2015 Volume 27 Issue 4 Pages 268-273
Objective: Interstitial lung disease (ILD) is an extra-articular involvement of rheumatoid arthritis (RA) and has a poor prognosis. It is difficult for rheumatologists to choose disease modified anti-rheumatic-drugs (DMARDs) to RA-ILD patients because DMARDs generally have adverse events such as drug-induced interstitial pneumonia. In the present study, we examined use examples of biological DMARDs (Bio) for RA with ILD.
Methods: There were 23 RA-ILD patients of 259 RA patients between April 2013 and March 2014 in our hospital. Of them there were 8 Bio cases (infliximab (IFX): 1 cases, tocilizumab (TCZ): 2 cases, abatacept (ABT): 3 cases, golimumab (GLM): 2 cases).
Results: The mean age was 61.3±5.0 years. There were 6 females. We chose Bio to RA-ILD patients with earlier stage and progressing class of Steinbrocker classification. There were 4 Bio-naïve cases and 4 Bio-switch cases. There were 4 cases with concomitant methotrexate therapy. All cases continued Bio more than 52 weeks without ILD deterioration. The PSL dose of all cases did not increase in 52 weeks.
Conclusions: The use of Bio for RA-ILD patients increases the risk of ILD deterioration. However, we decide to use Bio carefully to control RA disease activity. In the present study, we showed the possibility of using Bio to RA-ILD patients.
