Efficacy and Safety of Abatacept Treatment in Rheumatoid Arthritis Patients with Interstitial Lung Disease

Abstract

The aim of this retrospective study was to investigate the clinical outcomes of abatacept（ABT）treatment in rheumatoid arthritis（RA）patients with interstitial lung disease（ILD）. 17 cases（12 women and 5 men）were included in this study. We investigated characteristics of patients, treatment retention rate of ABT and reasons for discontinuation of ABT. The time course in disease activity, serum biomarkers, and prednisolone（PSL）dose, and respiratory function were also investigated（0/24 weeks/1 year/2 years/3 years）. Mean age was 72.4 years and mean RA disease duration was 10.1 years. Retention rate of ABT was 76% at 6 years. The reasons for discontinuation of ABT were lack of efficacy in 2 cases, malignant lymphoma in 1 case, and ILD exacerbation in 1 case. Time course of mean DAS28-CRP, CRP（mg/dl）, and MMP-3（ng/ml）were 5.0/2.8/2.7/2.5/2.5, 3.0/1.3/1.0/0.9/0.8, and 281/149/138/125/126, respectively. Values were significantly decreased at and after 24 weeks compared with baseline values. Time course of mean PSL dose（mg/day）was 4.6/3.3/3.3/1.9/2.4. PSL doses at and after 2 years were significantly lower than that at baseline. There was no significant deterioration in respiratory function. ABT was tolerable in RA patients with ILD included in this study. The safety of ABT for RA patients with ILD was suggested in several studies. However, ILD itself is a poor prognostic factor for RA and should be paid attention to.