Patients were then followed according to normal daily practice with semiannual outpatient visits. defined as “improved/stable (p?=?0.01). Current smoking habit (p?=?0.005) and concomitant methotrexate treatment (p?=?0.0078) were the two variables related to RA-ILD progression in multivariate regression analysis. Conclusion Treatment with ABA is associated with a RA-ILD stability or improvement in the 88.6% of patients. Current smoking habit and concomitant treatment with methotrexate are the modifiable factors associated with RA-ILD worsening. Key Points em ? Abatacept plays a favourable role in the control of RA-ILD, with a significant worsening in only 11.4% of patients during a 18-month follow-up period. /em em ? The predictive variables related to RA-ILD progression during abatacept therapy are the concomitant treatment with methotrexate and current smoking habit. /em Open in a separate window strong class=”kwd-title” Keywords: Abatacept, High-resolution computed tomography, Interstitial lung disease, Rheumatoid arthritis Albendazole sulfoxide D3 Introduction Rheumatoid arthritis (RA) is a progressive systemic autoimmune disorder characterized by articular and extra-articular manifestations affecting about 0.5% of the adult population in Western countries . Interstitial lung disease (ILD) is one of the most important extra-articular manifestations in RA . The prevalence of RA-ILD varies from 1 to 67% depending on Albendazole sulfoxide D3 the method used to assess lung involvement and the study design [3C6]. The Tead4 most commonly associated risk factors for predicting RA-ILD are advanced age, old age at onset of RA, male gender, smoking status and presence of anti-citrullinated peptide antibodies (ACPA) [7, 8]. In addition, some effective drugs used to treat RA can cause lung toxicity . High-resolution computed tomography (HRCT) of chest provides valuable information about ILD, including the pattern and extent of the disease . HRCT abnormalities are found in 48C68% of asymptomatic patients and 90% of symptomatic patients with RA [11, 12]. During an average follow-up of 1 1.5?years, up to 57% of patients with asymptomatic RA-ILD have experienced a HRCT progression . The usual interstitial pneumonia (UIP) pattern is more frequent in men and is associated with a worse prognosis, while the non-specific interstitial pneumonia (NSIP) pattern is more related to the female gender and has a better prognosis [14, 15]. The 5-year survival rate is 36% in patients with RA-ILD-UIP and 94% in patients with RA-ILD-NSIP, confirming the favourable outcome of patients with ?this last pattern . This scenario highlights the need for effective treatment for RA-ILD, but its management is still debated and somewhat controversial . In addition, the pulmonary toxicity of some disease-modifying anti-rheumatic drugs (DMARDs), particularly methotrexate (MTX), is still debated . Immunosuppressive treatments also increase the risk of infection and, in particular, of severe lung infection with a high rate of hospitalization. On the other hand, certain biologic DMARDs (bDMARDs) demonstrated a promising effectiveness in slowing or stopping the progression of RA-ILD. Among these, abatacept (ABA), a T lymphocyte co-stimulation antagonist used in the treatment of RA, has shown some efficacy in the treatment of RA-ILD. ABA is also promising in light of the reduced infectious risk if compared to other bDMARDs . However, the number of studies published on this issue is still small and mostly retrospective [19C21]. Therefore, the main aim of this study was to evaluate the efficacy and safety of ABA treatment in RA-ILD patients and, as Albendazole sulfoxide D3 a second aim, to identify predictors of an.
Patients were then followed according to normal daily practice with semiannual outpatient visits