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Interstitial lung involvement in rheumatoid arthritis patients treated with abatacept: a prospective observational study

1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25

 

  1. Rheumatology Unit, Policlinico Hospital of Modena, Italy.
  2. Rheumatology Unit, Guglielmo da Saliceto Hospital, AUSL Piacenza; and Department of Medicine and Surgery, University of Parma, Italy. marco.sebastiani@unipr.it
  3. Rheumatology Unit, University of Verona, Italy.
  4. Academic Rheumatology Centre, Department of Clinical and Biological Sciences, University of Turin, AO Mauriziano, Turin, Italy.
  5. Rheumatology Unit, Department of Experimental and Clinical Medicine, University of Florence, Italy.
  6. Rheumatology Unit, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari Aldo Moro, Bari, Italy.
  7. Rheumatology Unit, Policlinico Gaetano Martino, University of Messina, Italy.
  8. Rheumatology Department of Lucania, San Carlo Hospital of Potenza and ASP Basilicata, Potenza, Italy.
  9. Rheumatology Unit, Azienda Ospedaliero Universitaria Policlinico-San Marco di Catania, Italy.
  10. Rheumatology Unit, AUSL-IRCCS Reggio Emilia, Italy.
  11. Department of Clinical Sciences and Community Health, University of Milan, Italy.
  12. Rheumatology Unit, Spedali Civili di Brescia, Italy.
  13. Rheumatology Unit, Guglielmo da Saliceto Hospital, AUSL Piacenza; and University of Modena and Reggio Emilia, Modena, Italy.
  14. Rheumatology Unit, University of Verona, Italy.
  15. Academic Rheumatology Centre, Department of Clinical and Biological Sciences, University of Turin, AO Mauriziano, Turin, Italy.
  16. Rheumatology Unit, Department of Experimental and Clinical Medicine, University of Florence, Italy.
  17. Rheumatology Unit, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari Aldo Moro, Bari, Italy.
  18. Rheumatology Unit, Policlinico Gaetano Martino, University of Messina, Italy.
  19. Rheumatology Department of Lucania, San Carlo Hospital of Potenza and ASP Basilicata, Potenza; and Department of Health Sciences, University of Basilicata, Potenza, Italy.
  20. Department of Sciences and Methods for Engineering, University of Modena and Reggio Emilia, Modena, Italy.
  21. Respiratory Disease Unit, Guglielmo da Saliceto Hospital, AUSL Piacenza, Italy.
  22. Rheumatology Unit, University of Verona, Italy.
  23. University of Modena and Reggio Emilia, Modena; and Respiratory Disease Unit and Center for Rare Lung Disease, AOU Policlinico di Modena, Italy.
  24. Rheumatology Unit, AUSL-IRCCS Reggio Emilia; and University of Modena and Reggio Emilia, Modena, Italy.
  25. Rheumatology Unit, AUSL-IRCCS Reggio Emilia; and University of Modena and Reggio Emilia, Modena, Italy.

CER19224
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PMID: 41930652 [PubMed]

Received: 20/08/2025
Accepted : 19/12/2025
In Press: 02/04/2026

Abstract

OBJECTIVES:
The aim of this prospective multicentre observational study was to evaluate the clinical course and the incidence of interstitial lung disease (ILD) on a population affected with rheumatoid arthritis (RA).
METHODS:
Three hundred and twenty-five consecutive RA patients with an ongoing treatment with abatacept were enrolled in the study and followed for 24 months. At the enrolment, ILD was recorded in 20.6% of cases. Patients with ILD were followed according to the current clinical practice, while in patients without ILD, a careful assessment for respiratory symptoms and velcro crackles, also by mean of digital tools, was performed every six months. In this regard, each patient was evaluated by mean of VECTOR, a software able to identify velcro crackles with a diagnostic accuracy of 83.9% and a sensitivity of 93.2% in RA patients.
RESULTS:
During the study, no patients discontinued abatacept for a worsening of lung function, and no difference was recorded in two-year retention rate of abatacept between patients with and without ILD. After 24 months, ILD improved or remained stable in more than 85% of cases, while a worsening of radiologic picture was recorded in 14.9% of cases, mainly with usual interstitial pneumonia. Finally, the incidence rate of new-onset ILD was 0.39/100 patients/year.
CONCLUSIONS:
In conclusion, the presence of ILD did not affect the retention rate of the drug, suggesting a role for abatacept in the treatment of RA-ILD.

DOI: https://doi.org/10.55563/clinexprheumatol/yvkk4n

Rheumatology Article