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Antifibrotics in rheumatoid arthritis-associated interstitial lung disease – real-world data from a nationwide cohort

2024-07-01Artigo científico Acesso aberto
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dc.contributor.authorDuarte, Ana Catarin
dc.contributor.authorDuarte, Ana Catarina
dc.contributor.authorMarques Gomes, C.
dc.contributor.authorCorreia, M.
dc.contributor.authorMendes, B.
dc.contributor.authorMazeda, C.
dc.contributor.authorGuimarães, F.
dc.contributor.authorAbelha-Aleixo, J.
dc.contributor.authorGuerra, M.
dc.contributor.authorPereira da Costa, R.
dc.contributor.authorMeirinhos, T.
dc.contributor.authorSantos, M. J.
dc.contributor.institutionNOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)
dc.contributor.pblSociedade Portuguesa de Reumatologia
dc.date.accessioned2025-02-10T21:19:53Z
dc.date.available2025-02-10T21:19:53Z
dc.date.issued2024-07-01
dc.descriptionPublisher Copyright: © 2024 Sociedade Portuguesa de Reumatologia.
dc.description.abstractIntroduction: Interstitial lung disease (ILD) is the most common pulmonary manifestation of rheumatoid arthritis (RA) and is associated with an increased mortality. Clinical trials have shown that antifibrotics (nintedanib and pirfenidone) can slow the progression of connective tissue disease-associated ILD. This study aims to evaluate the effectiveness and tolerability of antifibrotics in a national, real-world cohort of patients with RA-ILD. Material and methods: We conducted an observational multicenter study of RA-ILD patients treated with antifibrotics, who were prospectively followed in Reuma.pt. Demographic and clinical data, pulmonary function tests (PFTs) results and adverse events (AEs) were collected. A linear mixed model with random intercept was used to compare PFT results within 12 (±6) months before to 12 (±6) months after antifibrotic initiation. Drug persistence was evaluated using Kaplan-Meier curves. Results: We included 40 RA-ILD patients, 27 (67.5%) initially treated with nintedanib and 13 (32.5%) with pirfenidone. Most of the patients were female (55%), and current or past smokers (52.5%). At antifibrotic initiation, mean age was 70.9 ± 7.1 years and median ILD duration 5.0 [IQR 2.3-7.5] years. A total of 20 patients were included in effectiveness analysis, with the use of antifibrotics interrupting the decline of forced vital capacity (FVC; decline 300 ± 500 mL in the year before antifibrotic initiation vs. improvement of 200 ± 400 mL in the year following antifibrotic initiation, p=0.336) and total lung capacity (TLC; decline 800 ± 300 mL in the year before antifibrotic initiation vs. improvement of 600 ± 900 mL in the year following antifibrotic initiation, p=0.147). However, diffusion capacity for carbon monoxide remained in decline (3% decline in the year before antifibrotic initiation vs. 2.9% decline in the year following antifibrotic initiation, p=0.75). AEs were reported in 16 (40%) patients and led to drug discontinuation in 12 (30%). Median duration of drug persistence was 150.3 weeks (95 %CI 11.0-289.6), with no difference between nintedanib and pirfenidone (p = 0.976). Conclusion: This study with real-world data corroborates the usefulness of antifibrotics in stabilizing lung function, based on FVC and TLC. However, AEs were frequently reported and were the main cause for drug discontinuation.en
dc.description.versionpublishersversion
dc.description.versionpublished
dc.format.extent7
dc.format.extent402190
dc.identifier.doi10.63032/POPM9413
dc.identifier.issn2795-4552
dc.identifier.otherPURE: 109185254
dc.identifier.otherPURE UUID: 5877ce12-fc97-4843-a0c5-05f77bee6d62
dc.identifier.otherScopus: 85211796758
dc.identifier.otherWOS: 001360399300003
dc.identifier.urihttp://hdl.handle.net/10362/178779
dc.identifier.urlhttps://www.scopus.com/pages/publications/85211796758
dc.language.isoeng
dc.peerreviewedyes
dc.subjectAntifibrotics
dc.subjectInterstitial lung disease
dc.subjectNintedanib
dc.subjectPirfenidone
dc.subjectRheumatoid arthritis
dc.subjectRheumatology
dc.titleAntifibrotics in rheumatoid arthritis-associated interstitial lung disease – real-world data from a nationwide cohorten
dc.typejournal article
degois.publication.firstPage182
degois.publication.issue3
degois.publication.lastPage188
degois.publication.titleARP rheumatology
degois.publication.volume3
dspace.entity.typePublication
person.familyNameDuarte
person.givenNameAna Catarina
person.identifier.orcid0000-0001-6128-2425
rcaap.rightsopenAccess
relation.isAuthorOfPublication85de9f95-03fc-4e9e-85f3-4ae029077c71
relation.isAuthorOfPublication.latestForDiscovery85de9f95-03fc-4e9e-85f3-4ae029077c71

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