Abatacept in patients with rheumatoid arthritis and interstitial lung disease: A national multicenter study of 63 patients

Fernández-Díaz, C.; Loricera, J.; Castañeda, Santos; López‐Mejías, Raquel; Ojeda-Garcia, C.; Olivé, Alejandro; Rodríguez-Muguruza, Samantha; Carreira, Patrícia; Pérez-Sandoval, Trinidad; Retuerto, Miriam; E, Cervantes-Pérez; Flores-Robles, Bryan J.; Hernández‐Cruz, Blanca; Urruticoechea, Ana; Maiz-Alonso, O.; Arboleya, Luis; Bonilla, Gema; Hernández-Rodríguez, Íñigo; Palma, D.; Delgado, C Romero; Expόsito-Molinero, R.; Ruibal-Escribano, A.; Álvarez-Rodríguez, Belén; Blanco-Madrigal, Juan María; Bernal, José Antonio; Vela-Casasempere, Paloma; Rodríguez–Gómez, Manuel; Fito, C.; Sanjuán, Francisco Miguel Ortíz; Narváez, Javier; Moreno, M.; López-Corbeto, Mireia; Mena-Vázquez, Natalia; Aguilera-Cros, Clara; Romero-Yuste, Susana; Ordoñez, S.; Villa-Blanco, Ignacio; Gonzélez-Vela, M. Carmen; Cuesta, Víctor Manuel Mora; Palmou-Fontana, Natalia; Hernández, José L.; González-Gay, Miguel Á.; Blanco, R.

doi:10.1016/j.semarthrit.2017.12.012

Cited by 140 publications

(101 citation statements)

References 47 publications

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“…Recently, some authors noted in case reports and retrospective studies the possible effectiveness and safety of ABA for the treatment of RA patients complicated by ILD, reporting stability of lung function during the follow-up period and the absence of severe adverse events [17][18][19][20][21][22]. In particular, no cases of AE of ILD were described during the therapy (only one case of AE two months after ABA discontinuation has been described in the literature [29]).…”

Section: Discussionmentioning

confidence: 99%

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Safety of Abatacept in Italian Patients with Rheumatoid Arthritis and Interstitial Lung Disease: A Multicenter Retrospective Study

Cassone

Manfredi

Atzeni

et al. 2020

JCM

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Background: Treatment of rheumatoid arthritis (RA)-related interstitial lung disease (ILD) is challenging, and many conventional and biologic disease-modifying anti-rheumatic drugs (DMARDs) have been associated with ILD development or progression. The aim of this multicentric retrospective study was to analyze the evolution of ILD in Italian RA-ILD patients treated with abatacept (ABA). Methods: All RA-ILD patients treated with ABA for at least six months were retrospectively evaluated. Serology, previous and concurrent therapies, chest high-resolution computer tomography (HRCT), forced vital capacity (FVC), and lung diffusion of carbon monoxide (CO, DLCO) were collected. Results: Forty-four patients were included; HRCT, FVC, and DLCO were analyzed at baseline, at one year, and at the end of follow-up. A remission or a low disease activity of RA was reached in 41/44 patients. Overall, FVC and DLCO remained stable or increased in 86.1% and 91.7% of patients, respectively, while HRCT was stable or improved in 81.4% of them. Previous and concurrent treatments, in particular, methotrexate, serology, age, sex, joint and lung disease duration were not associated with the outcome at univariate analysis. Conclusion: The management of RA-ILD patients remains a critical unmet medical need. Waiting for prospective controlled studies, ABA has shown a good safety profile in our cohort of Italian RA-ILD patients.

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Section: Discussionmentioning

confidence: 99%

“…In the last years, an increasing interest in ABA for use in RA-ILD treatment has emerged, based on its capacity to improve ILD in mice models [15,16]. Recently, some authors described the possible effectiveness and safety of ABA in the treatment of patients with RA-ILD [17][18][19][20][21][22].…”

Section: Introductionmentioning

confidence: 99%

Safety of Abatacept in Italian Patients with Rheumatoid Arthritis and Interstitial Lung Disease: A Multicenter Retrospective Study

Cassone

Manfredi

Atzeni

et al. 2020

JCM

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“…In an uncontrolled open-label Spanish registry, of 63 patients with RA-ILD treated with abatacept for 12 months, FVC % predicted remained stable in approximately two-thirds of patients and improved by ≥ 10% from baseline in approximately onefifth of patients [63]. A number of other retrospective/ This material has not been reviewed prior to release; therefore, the European Respiratory Society may not be responsible for any errors, omissions or inaccuracies, or for any consequences arising therefrom, in the content observational studies have shown preservation or improvement in lung function in patients with other autoimmune ILDs treated with immunosuppressants including polymyositis/dermatomyositis [59,64] and anti-synthetase syndrome [65,66]; however, these studies were uncontrolled and lung function was measured over limited time periods (1 to 4 years).…”

Section: Treatment Of Autoimmune Ildsmentioning

confidence: 99%

Progressive fibrosing interstitial lung disease associated with systemic autoimmune diseases

Fischer

Distler

2019

Clin Rheumatol

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Interstitial lung disease (ILD) is a common manifestation of systemic autoimmune diseases and a leading cause of death in these patients. A proportion of patients with autoimmune ILDs develop a progressive fibrosing form of ILD, characterized by increasing fibrosis on high-resolution computed tomography, worsening of lung function, and early mortality. Autoimmune disease-related ILDs have a variable clinical course and not all patients will require treatment, but all patients should be monitored for signs of progression. Apart from systemic sclerosis-associated ILD, the limited evidence to support the efficacy of immunosuppression as a treatment for ILDs is based mainly on small retrospective series and expert opinion. Non-clinical data suggest that there are commonalities in the mechanisms that drive progressive fibrosis in ILDs with an immunological trigger as in other forms of progressive fibrosing ILD. This suggests that nintedanib and pirfenidone, drugs known to slow disease progression in patients with idiopathic pulmonary fibrosis, may also slow the progression of ILD associated with systemic autoimmune diseases. In the SENSCIS® trial, nintedanib reduced the rate of ILD progression in patients with systemic sclerosis-associated ILD. The results of other large clinical trials will provide further insights into the role of anti-fibrotic therapies in the treatment of autoimmune disease-related ILDs.

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“…Corticosteroids in combination with immunosuppressive agents such as cyclosporine and cyclophosphamide may help with management of this disease; however, their efficacy in RA-ILD is usually extrapolated from experience with other CTD-ILDs due to a lack of evidence from controlled studies [41]. Rituximab and abatacept have been suggested as acceptable therapeutic choices for patients with RA-ILD; however, randomised studies are warranted to confirm these findings [43,44]. Pirfenidone, which has proven efficacy in patients with IPF, is currently under investigation as a therapeutic option for patients with RA-ILD (ClinicalTrials.gov identifier: NCT02808871) [40,45].…”

Section: Ctd-ildsmentioning

confidence: 99%

Pharmacological management of progressive-fibrosing interstitial lung diseases: a review of the current evidence

Richeldi

Varone

Bergna³

et al. 2018

Eur Respir Rev

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A proportion of patients with interstitial lung diseases (ILDs) are at risk of developing a progressive-fibrosing phenotype, which is associated with a deterioration in lung function and early mortality. In addition to idiopathic pulmonary fibrosis (IPF), fibrosing ILDs that may present a progressive phenotype include idiopathic nonspecific interstitial pneumonia, connective tissue disease-associated ILDs, hypersensitivity pneumonitis, unclassifiable idiopathic interstitial pneumonia, ILDs related to other occupational exposures and sarcoidosis. Corticosteroids and/or immunosuppressive therapies are sometimes prescribed to patients with these diseases. However, this treatment regimen may not be effective, adequate on its own or well tolerated, suggesting that there is a pressing need for efficacious and better tolerated therapies. Currently, the only approved treatments to slow disease progression in patients with IPF are nintedanib and pirfenidone. Similarities in pathobiological mechanisms leading to fibrosis between IPF and other ILDs that may present a progressive-fibrosing phenotype provide a rationale to suggest that nintedanib and pirfenidone may be therapeutic options for patients with the latter diseases.This review provides an overview of the therapeutic options currently available for patients with fibrosing ILDs, including fibrosing ILDs that may present a progressive phenotype, and explores the status of the randomised controlled trials that are underway to determine the efficacy and safety of nintedanib and pirfenidone.

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Abatacept in patients with rheumatoid arthritis and interstitial lung disease: A national multicenter study of 63 patients

Cited by 140 publications

References 47 publications

Safety of Abatacept in Italian Patients with Rheumatoid Arthritis and Interstitial Lung Disease: A Multicenter Retrospective Study

Safety of Abatacept in Italian Patients with Rheumatoid Arthritis and Interstitial Lung Disease: A Multicenter Retrospective Study

Progressive fibrosing interstitial lung disease associated with systemic autoimmune diseases

Pharmacological management of progressive-fibrosing interstitial lung diseases: a review of the current evidence

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