Subcutaneous vs intravenous abatacept in rheumatoid arthritis-interstitial lung disease. National multicentre study of 397 patients.

Autor: López-Maraver M; Rheumatology Department, Hospital Universitario Araba, Vitoria, Spain., Serrano-Combarro A; Rheumatology Department, Immunopathology Group, Marqués de Valdecilla University Hospital-IDIVAL, Santander, Spain., Atienza-Mateo B; Rheumatology Department, Immunopathology Group, Marqués de Valdecilla University Hospital-IDIVAL, Santander, Spain., Del Val N; Rheumatology Department, Hospital Universitario de Navarra, Pamplona, Spain., Casafont-Solé I; Rheumatology Department, H.U. Germans Trias i Pujol, Barcelona, Spain., Melero-Gonzalez RB; Rheumatology Department, C.H.U. de Ourense, Ourense, Spain., Pérez-Linaza A; Rheumatology Department, Hospital Puerta del Mar, Cádiz, Spain., Calvo Gutiérrez J; Rheumatology Department, HU Reina Sofía, Córdoba, Spain., Mena-Vázquez N; Rheumatology Department, Hospital Regional de Málaga, Málaga, Spain., Vegas-Revenga N; Rheumatology Department, Hospital Universitario Galdakao-Usansolo, Galdakao, Spain., Domínguez-Casas L; Rheumatology Department, Hospital San Agustín, Avilés, Spain., Loarce Martos J; Rheumatology Department, Hospital Ramón y Cajal, Madrid, Spain., Peralta Ginés CA; Rheumatology Department, Hospital Clínico Lozano Blesa, Zaragoza, Spain., Diez Morrondo C; Rheumatology Department, Hospital de León, León, Spain., Pérez Albaladejo L; Rheumatology Department, Hospital Universitario de Jaén, Jaén, Spain., López Sánchez R; Rheumatology Department, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas, Spain., Manzano Canabal MG; Rheumatology Department, Complejo Asistencial de Zamora, Zamora, Spain., Brandy-García AM; Rheumatology Department, Hospital Universitario Cabueñes, Gijón, Spain., López Viejo P; Rheumatology Department, Hospital Severo Ochoa, Leganés, Spain., Bonilla G; Rheumatology Department, H. Universitario La Paz, Madrid, Spain., Maiz-Alonso O; Rheumatology Department, Hospital de Donostia, San Sebastián, Spain., Carrasco-Cubero C; Rheumatology Department, CHU Infanta Cristina, Badajoz, Spain., Garijo Bufort M; Rheumatology Department, Hospital de Sagunto, Valencia, Spain., Moreno M; Rheumatology Department, Departamento Medicina UAB, Hospital Universitari Parc Taulí, Sabadell, Spain., Urruticoechea-Arana A; Rheumatology Department, H. Universitario Son Espases, Palma de Mallorca, Spain., Ordóñez-Palau S; Rheumatology Department, Hospital Universitario Arnau de Vilanova, Lleida, Spain., González-Montagut C; Rheumatology Department, Hospital Clínico Universitario de Valladolid, Spain., Giner Serret E; Rheumatology Department, Hospital Royo Villanova, Zaragoza, Spain., De Dios Jiménez De Aberasturi JR; Rheumatology Department, Hospital Universitario Araba, Vitoria, Spain., Lozano Morillo F; Rheumatology Department, HCD Gómez Ulla, Madrid, Spain., Vázquez Rodríguez T; Rheumatology Department, Complejo Hospitalario Universitario de Ferrol, Ferrol, Spain., Carreira PE; Rheumatology Department. University Hospital 12 de Octubre, Madrid, Spain., Blanco Madrigal JM; Rheumatology Department, Hospital Universitario Araba, Vitoria, Spain., Miguel Ibáñez B; Rheumatology Department, Complejo Asistencial de Salamanca, Salamanca, Spain., Rodríguez López M; Rheumatology Department, Hospital Clínico Santiago, A Coruña, Spain., Fernández-Díaz C; Rheumatology Department, Hospital Universitario Reina Sofía, Murcia, Spain., Loricera J; Rheumatology Department, Immunopathology Group, Marqués de Valdecilla University Hospital-IDIVAL, Santander, Spain., Ferraz-Amaro I; Rheumatology Department, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain., Ferrer-Pargada D; Pneumology Department, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain., Castañeda S; Rheumatology Department, Hospital de La Princesa, IIS-Princesa, Madrid, Spain., Blanco R; Rheumatology Department, Hospital Universitario Araba, Vitoria, Spain; Rheumatology Department, Immunopathology Group, Marqués de Valdecilla University Hospital-IDIVAL, Santander, Spain. Electronic address: rblancovela@gmail.com.
Jazyk: angličtina
Zdroj: Seminars in arthritis and rheumatism [Semin Arthritis Rheum] 2024 Oct; Vol. 68, pp. 152517. Date of Electronic Publication: 2024 Jul 18.
DOI: 10.1016/j.semarthrit.2024.152517
Abstrakt: Background: Evidence on abatacept (ABA) utility for rheumatoid arthritis (RA) - associated interstitial lung disease (ILD) is growing. Clinical trials have shown equivalence in subcutaneous (SC) and intravenous (IV) administration of ABA for articular manifestations. However, this has not been studied in respiratory outcomes.
Objective: To compare the effectiveness of ABA in RA-ILD patients according to the route of administration.
Methods: National retrospective multicentre study of RA-ILD patients on treatment with ABA. They were divided into 2 groups: a) IV, and b) SC. The following outcomes were analysed from baseline to final follow-up using linear mixed models: a) forced vital capacity (FVC), b) diffusing capacity of the lungs for carbon monoxide (DLCO), c) chest high resolution computed tomography (HRCT), d) dyspnoea, e) RA activity, and f) sparing corticosteroids effect.
Results: A total of 397 patients were included (94 IV-ABA and 303 SC-ABA), median follow-up of 24 [10-48] months. After adjustment for possible confounders, FVC and DLCO remained stable during the first 24 months without differences between IV-ABA and SC-ABA (p = 0.6304 and 0.5337). Improvement/ stability of lung lesions in HRCT was observed in 67 % of patients (75 % IV-ABA, 64 % SC-ABA; p = 0.07). Dyspnoea stabilized/ improved in 84 % of patients (90 % IV-ABA, 82 % SC-ABA; p = 0.09). RA - disease activity improved in both groups. No statistically significant differences regarding any of the variables studied between the two groups were found. ABA was withdrawn in 87 patients (21.9 %), 45 % IV-ABA and 37 % SC-ABA (p = 0.29). ILD worsening and articular inefficacy were the most common reasons for ABA discontinuation.
Conclusion: In patients with RA-ILD, ABA seems to be equally effective regardless of the route of administration.
Competing Interests: Declaration of competing interest Disclosures that may be interpreted as constituting of possible conflict(s) of interest for the study: B. A.-M. received grants/research supports from Abbvie and Roche and had consultation fees/participation in company-sponsored speaker´s bureau from Pfizer, Celgene, Novartis, Sanofi, Janssen, UCB and Lilly, outside the submitted work; N.V.-R. has received fees in company-sponsored speaker's bureau and research supports from AbbVie, Lilly, Celgene, Grünenthal, UCB Pharma, Nordic Pharma, MSD and Rubió; L.C.D.-C has received research supports and participation in company-sponsored speaker's bureau from Abbvie, Janssen, Lilly and Celgene; J.L.M has received fees in company-sponsored speaker's bureau from Boehringer Ingelheim, Bristol-Myers Squibb (BMS) and Galapagos and had consultation fees from Boehringer Ingelheim; G.B has received fees in company-sponsored speaker's bureau from Bristol-Myers Squibb (BMS); A.U.-A. has received grants/research supports from Abbvie, Galápagos, Novartis, GSK, Astrazeneca, Janssen, Pfizer and Amgen; C.F.-D. has received fees in company-sponsored speaker's bureau from: Janssen, Galápagos, Amgen, Bristol Myers Squibb (BMS); I. F.-A. has received grants/research supports from Abbott, MSD, Janssen, and Roche, as well as consultation fees from company sponsored speakers bureaus associated with Abbott, Pfizer, Roche, Sanofi, Celgene, and MSD; S.C. has received research supports from MSD and Pfizer and had consultation fees/participation in company-sponsored speaker's bureau from Amgen, BMS, Eli-Lilly, MSD, Roche, and UCB. S. C. is also assistant professor of the cátedra EPID-Future, funded by UAM-Roche, Universidad Autónoma de Madrid (UAM), Spain; R. B. received grants/research support from AbbVie, MSD, and Roche, and had consultation fees/participation in a company-sponsored speaker's bureau from AbbVie, Pfizer, Roche, Bristol-Myers, Janssen, and MSD. The rest of the authors have declared no conflicts of interest.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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