FRI0078 Prospective follow-up of a cohort of patients with interstitial lung diseaseassociated with rheumatoid arthritis in treatment with dmard
Authors: N. Mena-Vázquez, C. Gomez-Cano, L. Perez-Albaladejo, S. Manrique-Arija, C. Romero-Barco, C. Aguilar-Hurtado, I. Ureña-Garnica, F. Jiménez-Núñez, M. Ordóñez-Cañizares, C. Fuego, M. Padin-Martin, R. Caliz-Caliz, A. Fernández-Nebro
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Objectives</h3> To describe prospectively the evolution of interstitial lung disease (ILD) in RA treated with modifying antirheumatic drugs (DMARDs) in clinical practice. <h3>Methods</h3> Design: Multicenter prospective observational cohort. Patients: Patients with RA (ACR/<sup>EULAR 2010</sup> criteria) and ILD (American Thoracic Society) from different centres of Málaga, Valme Hospital of Sevilla and Virgen Nieves of Granada were included. Protocol: All patients with RA and ILD who visited clinic from 2015 to 2017 were recruited. They were reviewed according to a predetermined protocol for data collection. Resolution Computed Tomography (HRCT), Pulmonary function test (PFT) and echocardiogram were requested for all patients who did not have it in the last year. This visit was marked as v0 (index date). At 12 months (v12) the joint assessment (DAS28), echocardiogram, PTF and HRCT were again evaluated. HRCT's were assessed by the same radiologist. Outcomes: At v12:(<sup>1</sup>improvement (ie improvement in FVC ≥10% or DLCO ≥15% and no radiological progression),<sup>2</sup> non-progression (stabilisation or improvement in FVC ≤10% or DLCO &lt;15% and no radiological progression),(<sup>3</sup> progression (worsening of FVC &gt;10% or DLCO &gt;15% and radiological progression), or<sup>4</sup> death due to ILD. Variables: Description of ILD type and lung function by PTF, HRCT. Presence of PTH by echocardiogram and dyspnoea. Disease activity by DAS28-ESR;Adverse events during the follow-up period. Statistical analysis:Descriptive analysis and Wilcoxon or T test between the v0 and v12. One factor ANOVA between sDMARD, bDMARD and combination therapy groups. <h3>Results</h3> The main characteristics at V0 of the patients (n=41) are shown in the table 1. Nine patients (21.9%) received a sDMARDs with a bDMARDs;25 patients (60.9%) monotherapy with sDMARD and 7 (17.0%) monotherapy with bDMARDs (table 1). Nine patients (21.9%) had improvement (2 with MTX, 1 with MTX +HCQ, 2 with RTX, 2 HCQ +RTX, 1 MMF +RTX and 1 with ABA); 24 patients (58.5%) remained stable (6 with MTX, 6 with LFN, 3 with HCQ, 1 AZA, 1 SSZ, 1 MMF, 1 TCZ, 2 ABA, 1 MTX +ETN, 1 HCQ +RTX, 1 HCQ +ADA, 1 RTX +MMF); and 7 (17.0%) got worse of ILD (2 with MTX developed lung nodules not known, 2 with LFN, 1 with LFN +IFX, 1 with ETN +MTX and 1 with SSZ). One patient died due to respiratory infection (with RTX). Two patients developed PPH. We did not find significant differences between Vo DAS28 and v12 (2.61 [0.74] vs 2.54 [1.12];p=0.684) or in HAQ (1.12 [0.89] vs 1.23 [0.73],p=0.368). There were no significant differences in PTF, HRCT or DAS28 between sDMARD, bDMARD and combination therapy groups. During the follow-up period 27 patients had infections, the majority (53.7%) respiratory infection. <h3>Conclusions</h3> Most patients with RA and ILD who are receiving treatment with DMARD (80.5%) remained stable or improved after at least one year of both synthetic and biological DMARD treatment. More prospective studies are necessary to identify the influence of DMARDs in this evolution. <h3>Disclosure of Interest</h3> None declared