Effect of abatacept versus csDMARDs on rheumatoid arthritis-associated interstitial lung disease
- Author:
Kyung-Ann LEE
1
;
Bo Young KIM
;
Sung Soo KIM
;
Yun Hong CHEON
;
Sang-Il LEE
;
Sang-Hyon KIM
;
Jae Hyun JUNG
;
Geun-Tae KIM
;
Jin-Wuk HUR
;
Myeung-Su LEE
;
Yun Sung KIM
;
Seung-Jae HONG
;
Suyeon PARK
;
Hyun-Sook KIM
Author Information
- Publication Type:2
- From:The Korean Journal of Internal Medicine 2024;39(5):855-864
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background/Aims:To compare the effects of abatacept and conventional synthetic disease modifying anti-rheumatic drugs (csDMARDs) on the progression and development of rheumatoid arthritis-associated interstitial lung disease (RA-ILD).
Methods:This multi-center retrospective study included RA patients receiving abatacept or csDMARDs who underwent at least two pulmonary function tests and/or chest high-resolution computed tomography (HRCT). We compared the following outcomes between the groups: progression of RA-ILD, development of new ILD in RA patients without ILD at baseline, 28-joint Disease Activity Score with the erythrocyte sedimentation rate (DAS28-ESR), and safety. Longitudinal changes were compared between the groups by using a generalized estimating equation.
Results:The study included 123 patients who were treated with abatacept (n = 59) or csDMARDs (n = 64). Nineteen (32.2%) and 38 (59.4%) patients treated with abatacept and csDMARDs, respectively, presented with RA-ILD at baseline. Newly developed ILD occurred in one patient receiving triple csDMARDs for 32 months. Among patients with RA-ILD at baseline, ILD progressed in 21.1% of cases treated with abatacept and 34.2% of cases treated with csDMARDs during a median 21-month follow-up. Longitudinal changes in forced vital capacity and diffusing capacity for carbon monoxide were comparable between the two groups. However, the abatacept group showed a more significant decrease in DAS28-ESR and glucocorticoid doses than csDMARDs group during the follow-up. The safety of both regimens was comparable.
Conclusions:Abatacept and csDMARDs showed comparable effects on the development and stabilization of RA-ILD. Nevertheless, compared to csDMARDs, abatacept demonstrated a significant improvement in disease activity and led to reduced glucocorticoid use.
