SAT0075 ABATACEPT IN COMBINATION WITH METOTREXATE IN PATIENTS WITH RHEUMATOID ARTHRITIS ASSOCIATED TO INTERSTITIAL LUNG DISEASE: NATIONAL MULTICENTER STUDY OF 263 PATIENTS
Authors: C. Fernández-Díaz, S. Castañeda, R. Melero, J. Loricera, F. Ortiz-Sanjuán, A. Juan-Mas, C. Carrasco-Cubero, S. Rodriguéz-Muguruza, S. Rodrigez-Garcia, R. Castellanos-Moreira, R. Almodovar, C. Aguilera Cros, I. Villa-Blanco, S. Ordoñez, S. Romero-Yuste, C. Ojeda-Garcia, M. Moreno, G. Bonilla, I. Hernández-Rodriguez, M. Lopez Corbeto, J. L. Andréu Sánchez, T. Pérez Sandoval, A. López Robles, P. Carreira, N. Mena-Vázquez, C. Peralta-Ginés, A. Urruticoechea-Arana, L. M. Arboleya Rodríguez, J. Narváez, D. Palma Sanchez, O. Maiz-Alonso, J. Fernández-Leroy, I. Cabezas-Rodriguez, I. Castellví, A. Ruibal-Escribano, J. De Dios-Jiménez Aberásturi, P. Vela-Casasempere, C. González-Montagut Gómez, J. M. Blanco, N. Alvarez-Rivas, N. Del-Val, M. Rodíguez-Gómez, E. Salgado-Pérez, C. Fernández-López, E. C. Cervantes Pérez, A. Devicente-Delmas, B. Garcia-Magallon, C. Hidalgo, S. Fernández, E. García-Fernández, R. López-Sánchez, S. Castro, P. Morales-Garrido, A. García-Valle, R. Expósito, L. Exposito-Perez, L. Pérez Albaladejo, Á. García-Aparicio, R. Blanco, M. A. González-Gay
Journal: Annals of the Rheumatic Diseases (2020)

Background: Interstitial Lung Disease (ILD) is an extra-articular complication of rheumatoid arthritis (RA) that is associated with increased morbidity and mortality. Conventional disease-modifying drugs (DMARDs) such as methotrexate (MTX) have been implicated in the development and exacerbation of a pre-existing ILD. Objectives: The aim of our study was to check the influence of combined MTX treatment in patients with RA-ILD treated with abatacept (ABA). Methods: National multicentre retrospective registry of 263 patients with RA-ILD treated with ABA. RA was diagnosed according to the ACR classification criteria of 1987 or by the EULAR/ACR criteria of 2010. ILD was diagnosed by high resolution computed tomography (HRCT). In this study we have done a subanalysis of the 46 patients treated with ABA in combination with MTX (ABA+MTX) vs. 217 patients treated with ABA in monotherapy or in combination with other synthetic DMARDs. Efficacy was evaluated according to the following parameters: a) Dyspnoea (MMRC) considering variations ≥ 1; b) Lung function test (LFT) considering variations ≥ 10% in FVC and a variation of DLCO ≥ 10%; c) Imaging test (HRCT) d) DAS28 score e) prednisone dose. Variables were collected at the beginning of the study and at months 3, 6, 12 and then every 12 months until a maximum of 60 months. Results: 263 patients with ILD associated with RA were included in the study with mean age 64.64±10 years. RF or CCPA were positive in 235 (89.4%) and 233 (88.6%) cases, respectively, with a mean follow-up of 22.7±19.7 months. Baseline characteristics of both groups are shown in table 1, while data obtained during evolution of this complication are presented in Figure 1. Conclusion: Despite the baseline differences of both groups, the good evolution in the ABA+MTX subgroup suggests that this therapeutic strategy can be a safe combination for patients with RA-ILD. ABA with MTX (n=46) ABA w/t MTX (n=217) P Sex (F/M) 28/18 122/95 0.625 Age (years) 65.11±10.21 6.2±9.8 0.202 RF/CCPA + (%) 91.3/91.3 89.8/90.1 0.810 Smoking or past smoking (%) 47.8 55.1 0.417 Follow-up (months) 22.73±18.00 22.3±20.85 0.916 DAS28 at baseline 4.08±1.51 4.61±1.47 0.056 DAS28 at last visit 3.00±1.46 3.13±1.31 0.642 Prednisone at baseline, median (IQR) (mg) 5 (5-7.5) 7.75 (5-15) 0.008* Prednisone at the end of study, median (IQR) (mg) 5 (1-5) 5 (5-7.5) 0.032* DLCO at baseline (%) 66.85±19.04 65.43±18.21 0.823 DLCO at the end of study (%) 66.05±20.95 65.17±19.72 0.831 FVC at baseline (%) 90.06±17.77 85.40±21.56 0.164 FVC at the end of study (%) 90.58±15,45 84.21±21.49 0.038* Disclosure of Interests: Carlos Fernández-Díaz Speakers bureau: Brystol Meyers Squibb, Santos Castañeda: None declared, Rafael Melero: None declared, J. Loricera: None declared, Francisco Ortiz-Sanjuán: None declared, A. Juan-Mas: None declared, Carmen Carrasco-Cubero Speakers bureau: Janssen, MSD, AbbVie, Novartis, Bristol Myers Squibb, and Celgene, S, Rodriguéz-Muguruza: None declared, S. Rodrigez -Garcia: None declared, R. Castellanos-Moreira: None declared, RAQUEL ALMODOVAR Speakers bureau: Abbvie, Celgene, Janssen, Lilly, Novartis, Pfizer. , CLARA AGUILERA CROS: None declared, Ignacio Villa-Blanco Consultant of: UCB, Speakers bureau: Novartis, MSD, Lilly, Sergi Ordoñez: None declared, Susana Romero-Yuste: None declared, C. Ojeda-Garcia: None declared, Manuel Moreno: None declared, Gemma Bonilla: None declared, I. Hernández-Rodriguez: None declared, Mireia Lopez Corbeto: None declared, José Luis Andréu Sánchez: None declared, Trinidad Pérez Sandoval: None declared, Alejandra López Robles: None declared, Patricia Carreira Grant/research support from: Actelion, Roche, MSD, Consultant of: GlaxoSmithKline, VivaCell Biotechnology, Emerald Health Pharmaceuticals, Boehringer Ingelheim, Roche, Speakers bureau: Actelion, GlaxoSmithKline, Roche, Natalia Mena-Vázquez: None declared, C. Peralta-Ginés: None declared, ANA URRUTICOECHEA-ARANA: None declared, Luis Marcelino Arboleya Rodríguez: None declared, J. Narváez: None declared, DESEADA PALMA SANCHEZ: None declared, Olga Maiz-Alonso: None declared, J. Fernández-Leroy: None declared, I. Cabezas-Rodriguez: None declared, Ivan Castellví Consultant of: Boehringer Ingelheim, Actelion, Kern Pharma, Speakers bureau: Boehringer Ingelheim, Actelion, Bristol-Myers Squibb, Roche, A. Ruibal-Escribano: None declared, JR De Dios-Jiménez Aberásturi: None declared, Paloma Vela-Casasempere: None declared, C. González-Montagut Gómez: None declared, J M Blanco: None declared, Noelia Alvarez-Rivas: None declared, N. Del-Val: None declared, M. Rodíguez-Gómez: None declared, Eva Salgado-Pérez: None declared, Carlos Fernández-López: None declared, E.C. Cervantes Pérez: None declared, A. Devicente-DelMas: None declared, Blanca Garcia-Magallon Consultant of: MSD, Speakers bureau: Pfizer, Amgen, Celgene, MSD, Cristina Hidalgo: None declared, Sabela Fernández: None declared, Edilia García-Fernández: None declared, R. López-Sánchez: None declared, S. Castro: None declared, P. Morales-Garrido: None declared, Andrea García-Valle: None declared, Rosa Expósito: None declared, L. Exposito-Perez: None declared, Lorena Pérez Albaladejo: None declared, Ángel García-Aparicio: None declared, Ricardo Blanco Grant/research support from: AbbVie, MSD, and Roche, Speakers bureau: AbbVie, Pfizer, Roche, Bristol-Myers, Janssen, and MSD, Miguel A González-Gay Grant/research support from: Pfizer, Abbvie, MSD, Speakers bureau: Pfizer, Abbvie, MSD