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Effect of abatacept versus conventional synthetic disease modifying anti-rheumatic drugs on rheumatoid arthritis-associated interstitial lung disease

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Author(s)
Kyung-Ann LeeBo Young KimSung Soo KimYun Hong CheonSang-Il LeeSang-Hyon KimJae Hyun JungGeun-Tae KimJin-Wuk HurMyeung-Su LeeYun Sung KimSeung-Jae HongSuyeon ParkHyun-Sook Kim
Keimyung Author(s)
Kim, Sang Hyon
Department
Dept. of Internal Medicine (내과학)
Journal Title
Korean J Intern Med
Issued Date
2024
Volume
39
Issue
5
Keyword
ArthritisrheumatoidLung diseasesinterstitialDisease progressionAbataceptAntirheumatic agents
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.
Keimyung Author(s)(Kor)
김상현
Publisher
School of Medicine (의과대학)
Type
Article
ISSN
1226-3303
Source
https://kjim.org/journal/view.php?doi=10.3904/kjim.2023.207
DOI
10.3904/kjim.2023.207
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/45829
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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