Hospital Universitario Marqués de Valdecilla, IDIVAL Santander, Spain
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Ana Serrano-Combarro1, Belén Atienza-Mateo2, libe Ibarrola-Paino3, Ivette Casafont-Sole4, Rafael Benito Melero-Gonzalez5, Alba Perez Linaza6, Santos Castañeda7, Rafaela Ortega Castro8, Natalia Mena Vazquez9, Nuria Vegas Revenga10, Lucia Cristina Dominguez Casas11, Elena Cañadillas-Sanchez12, Miriam Retuerto-Guerrero13, Lorena Perez-Albadalejo14, Ruben Lopez-Sanchez15, MARIA GUADALUPE MANZANO CANABAL16, Anahy Maria Brandy-Garcia17, Patricia Lopez-Viejo18, Gema Bonilla19, Olga Maiz-Alonso20, Carmen carrasco-Cubero21, Marta Garijo Bufort22, Mireia Moreno23, Ana Urruticoechea24, Sergio Ordonez-Palau25, Carmen Gonzalez-Montagut Gomez26, andrea Garcia-Valle27, Marta López28, Fernando Lozano29, Tomás Vazquez-Rodriguez30, Maria Martin-Lopez31, Juan Maria Blanco-Madrigal32, Cristina Arciniega33, Ignacio Brana Abascal34, Jesus Loarce-Martos35, Emilio Giner-Serret36, Virginia Ruiz-Esquide37, Clara ventin-Rodriguez38, Marina Rodriguez-lopez39, Pablo Andujar-Brazal40, Julia Fernandez-Melon41, Lilian Maria Lopez42, Antonio Juan Mas43, carlos Fernandez-Diaz44, Javier Loricera45, Diego Ferrer46 and Ricardo Blanco47, 1Hospital Universitario Marques de Valdecilla, IDIVAL, Santander, Spain, 2Rheumatology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain, 3Hospital Universitario de Navarra, Pamplona, Spain, 4Hospital Universitari Germans Trias i Pujol, Badalona, Spain, 5CHU Vigo, O Carballino, Spain, 6SERV. REUMATOLOGIA, Cadiz, Spain, 7Hospital Universitario de la Princesa, Madrid, Spain, 8Hospital Reina Sofía, Cordoba, Spain, 9IBIMA, Málaga, Spain, 10Hospital Galdakao- Usansolo, Galdakao, Spain, 11Hospital Universtario San Agustin, Oviedo, Spain, 12Department of Rheumatology, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain, 13Rheumatology, Hospital Universitario de León, León, Spain, 14Division of Rheumatology, Hospital Universitario de Jaén, Jaén, Spain, 15Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Spain, 16CAZA, Salamanca, Spain, 17Hospital Germans Trias i Pujol, Badalona, Spain, 18Division of Rheumatology, Hospital Severo Ochoa, Leganéz, Spain, 19Department of Rheumatology, Hospital Clínico Universitario La Paz, Madrid, Spain, 20University Hospital Donostia, San Sebastian, Spain, 21Department of Rheumatology, Hospital Universitario de Badajoz, Badajoz, Spain, 22Hospital de Sagunto, Valencia, Spain, 23Parc Tauli Hospital Universitari, I3PT(UAB), Barcelona, Spain, 24Hospital Can Misses, Ibiza, Spain, 25H. Arnau de Vilanova, Lleida, Spain, 26H. Clínico Universitario de Valladolid, Valladolid, Spain, 27Division of Rheumatology, Complejo Asistencial Universitario de Palencia, Palencia, Spain, 28Hospital Universitario Arava, Pamplona, Spain, 29Hospital Universitario 12 de Octubre, Madrid, Spain, 30Rheumatology, Complejo Hospitalario Universitario de Ferrol, A Coruña, Spain, 31Hospital 12 de Octubre, Madrid, Spain, 32Division of Rheumatology, H. Universitario de Basurto, Bilbao, Spain, 33Hospital de Mérida, Mérida, Spain, 34Division of Rheumatology, Hospital Universitario Central de Asturias, Oviedo, Spain, 35Ramón y Cajal University Hospital, Madrid, Spain, 36Hospital Royo Villanova, Teruel, Spain, 37Hospital Clinic, Rheumatology, Barcelona, Spain, 38Division of Rheumatology, Hospital Universitario de A Coruña, A Coruña, Spain, 39Division of Rheumatology, Hospital Clínico Universitario de Santiago, La Coruna, Spain, 40Division of Rheumatology, Hospital Universitario Doctor Peset, Valencia, Spain, 41Division of Rheumatology, Hospital Universitario Son Espases, Palma de Mallorca, Spain, 42Division of Rheumatology, Hospital Universitario Son Llàtzer, Mallorca, Spain, 43Son Llazter University Hospital, Palma, Spain, 44Division of Rheumatology, Hospital Universitario Reina Sofía, Murcia, Spain, 45Hospital Universitario Marqués de Valdecilla, Santander, Spain, 46Division of Pneumology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain, 47Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain
Background/Purpose: Interstitial lung disease (ILD) is a severe extra-articular manifestation of rheumatoid arthritis (RA). Abatacept (ABA) has demonstrated efficacy in RA-ILD. Clinical trials have shown equivalence in subcutaneous (SC) and intravenous (IV) administration of ABA for articular manifestations. However, it has not been studied in RA-ILD. Our objective was tocompare the effectiveness of ABA in RA-ILD patients according to the route of administration (IV-ABA vs SC-ABA).
Methods: National multicenter study of RA-ILD patients on treatment with ABA. They were divided into 2 groups according to the route of administration: a) IV, and b) SC. We analyzed from baseline the following outcomes in both groups: a) forced vital capacity (FVC), b) diffusing capacity of the lungs for carbon monoxide (DLCO), c) chest high resolution computed tomography (HRCT), d)dyspnea (assessed with the modified Medical Research Council scale), e) arthritis activity (assessed with DAS28-ESR or described in clinical records), and f) sparing corticosteroids effect.
Results: We studied a total of 509 [SC-ABA/IV-AB; 360/100 (available data)] patients. Baseline demographic and clinical characteristics are shown in Table 1.Patients were followed-up for a median [IQR] of 24 [7-48] months.FVC and DLCO remain stable during the first 24 months in both SC-ABA and IV-ABA [Figure 1]. Dyspnea stabilized or improved in 84% of patients (89% of IV-ABA; 82% of SC-ABA). ABA was withdrawn in 106 patients: 81(34%) in SC-ABA group and 25 (40%) in IV-ABA group. ILD worsening and articular inefficacy were the most common reasons of ABA discontinuation.
Conclusion: In RA-ILD, ABA seems equally effective and safe regardless of the route of administration IV or SC.
Table 1. Main general features at baseline of RA-ILD patients with subcutaneous vs intravenous ABA.
Figure 1. Evolution of pulmonary function tests (mean % of the predicted FVC and DLCO) in RA-ILD patients with SC-ABA vs IV-ABA therapy at baseline and 24 months.
A. Serrano-Combarro: None; B. Atienza-Mateo: None; l. Ibarrola-Paino: None; I. Casafont-Sole: None; R. Melero-Gonzalez: None; A. Perez Linaza: None; S. Castañeda: None; R. Ortega Castro: None; N. Mena Vazquez: None; N. Vegas Revenga: None; L. Dominguez Casas: None; E. Cañadillas-Sanchez: None; M. Retuerto-Guerrero: None; L. Perez-Albadalejo: None; R. Lopez-Sanchez: None; M. MANZANO CANABAL: None; A. Brandy-Garcia: None; P. Lopez-Viejo: None; G. Bonilla: None; O. Maiz-Alonso: None; C. carrasco-Cubero: None; M. Garijo Bufort: None; M. Moreno: None; A. Urruticoechea: None; S. Ordonez-Palau: None; C. Gonzalez-Montagut Gomez: None; a. Garcia-Valle: None; M. López: None; F. Lozano: None; T. Vazquez-Rodriguez: None; M. Martin-Lopez: None; J. Blanco-Madrigal: None; C. Arciniega: None; I. Brana Abascal: None; J. Loarce-Martos: Boehringer-Ingelheim, 6, Bristol-Myers Squibb(BMS), 6, Galapagos, 6; E. Giner-Serret: None; V. Ruiz-Esquide: None; C. ventin-Rodriguez: None; M. Rodriguez-lopez: None; P. Andujar-Brazal: None; J. Fernandez-Melon: None; L. Lopez: None; A. Juan Mas: None; c. Fernandez-Diaz: None; J. Loricera: None; D. Ferrer: None; R. Blanco: AbbVie, 5, 6, Amgen, 6, AstraZeneca, 2, BMS, 6, Eli Lilly, 6, Galapagos, 2, 6, Janssen, 2, 6, MSD, 6, Novartis, 2, 6, Pfizer, 2, 6, Roche, 5, 6, Sanofi, 6.
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