• Modern rheumatology · May 2019

    Long-term deterioration of interstitial lung disease in patients with rheumatoid arthritis treated with abatacept.

    • Takeshi Mochizuki, Katsunori Ikari, Koichiro Yano, Motoaki Sato, and Ken Okazaki.
    • a Department of Rheumatology , Kamagaya General Hospital , Chiba , Japan.
    • Mod Rheumatol. 2019 May 1; 29 (3): 413-417.

    ObjectiveTo examine the deterioration of interstitial lung disease (ILD) in patients with rheumatoid arthritis (RA) treated with abatacept over the long-term.MethodsWe examined 131 patients with RA who had been treated with abatacept for more than 1 year. All patients underwent high-resolution computed tomographic (HRCT) scanning of the chest before administration of abatacept, and we examined deterioration of ILD over a follow-up period after administration of abatacept was initiated.ResultsEleven patients (8.4%) showed deterioration of ILD over a mean follow-up period of 47.8 months. The factors related to ILD deterioration were use of methotrexate (MTX) [odds ratio 12.75, 95% confidence interval (CI) 1.09-148.77], and change in Krebs von-den Lungen-6 (odds ratio 1.00, 95% CI 1.00-1.01), according to multivariate logistic regression analysis.ConclusionMTX in patients with RA treated with abatacept was a risk factor for deterioration of ILD. Discontinuation of MTX should be considered one of treatment reduction to prevent the deterioration of ILD.

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