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Efficacy and safety of tofacitinib in rheumatoid arthritis-associated interstitial lung disease: TReasure real-life data

1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18

 

  1. Division of Rheumatology, Department of Internal Medicine, Hacettepe University, Medical Faculty, Ankara, Turkey.
  2. Division of Rheumatology, Department of Internal Medicine, Hacettepe University, Medical Faculty, Ankara, Turkey. dr.emrebilgin@gmail.com
  3. Division of Rheumatology, Department of Internal Medicine, Ankara City Hospital, Ankara, Turkey.
  4. Division of Rheumatology, Department of Internal Medicine, Gazi University, Medical Faculty, Ankara, Turkey.
  5. Division of Rheumatology, Department of Internal Medicine, Gazi University, Medical Faculty, Ankara, Turkey.
  6. Division of Rheumatology, Department of Internal Medicine, University of Health Sciences Turkey, Gulhane Faculty of Medicine, Ankara, Turkey.
  7. Division of Rheumatology, Department of Internal Medicine, Ankara University, Medical Faculty, Ankara, Turkey.
  8. Division of Rheumatology, Department of Internal Medicine, Uludag University, Medical Faculty, Bursa, Turkey.
  9. Division of Rheumatology, Department of Internal Medicine, Uludag University, Medical Faculty, Bursa, Turkey.
  10. Division of Rheumatology, Department of Internal Medicine, Yıldırım Beyazıt University, Medical Faculty, Ankara, Turkey.
  11. Division of Rheumatology, Department of Internal Medicine, Akdeniz University, Medical Faculty, Antalya, Turkey.
  12. Division of Rheumatology, Department of Internal Medicine, Mustafa Kemal University, Medical Faculty, Hatay, Turkey.
  13. University of Health Sciences Basaksehir Cam and Sakura State Hospital, Istanbul, Turkey.
  14. Pfizer Turkey, Istanbul, Turkey.
  15. Pfizer Turkey, Istanbul, Turkey.
  16. Pfizer Turkey, Istanbul, Turkey.
  17. Division of Rheumatology, Department of Internal Medicine, Hacettepe University, Medical Faculty, Ankara, Turkey.
  18. Division of Rheumatology, Department of Internal Medicine, Hacettepe University, Medical Faculty, Ankara, Turkey.

CER15220
2022 Vol.40, N°11
PI 2071, PF 2077
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PMID: 35084323 [PubMed]

Received: 06/10/2021
Accepted : 06/12/2021
In Press: 25/01/2022
Published: 04/11/2022

Abstract

OBJECTIVES:
Rheumatoid arthritis associated interstitial lung disease (RA-ILD) is a major concern in RA. These patients have been included in clinical trials and in the post-marketing setting of RA patients using tofacitinib. We aimed to assess the real-life efficacy and safety of tofacitinib in patients with RA-ILD.
METHODS:
RA patients with ILD diagnosis based on the HRCT images of the lungs from eight different centres recruited to study. As a control group, RA patients without ILD under tofacitinib were included. Demographic data, patients’ characteristics, available pulmonary function tests regarding RA and RA-ILD at the visit in which tofacitinib was initiated and for the last follow-up visit under tofacitinib were recorded. Reasons for tofacitinib discontinuation were also recorded. Drug retention rates were compared by log-rank test. p-value <0.05 was considered statistically significant.
RESULTS:
A total of 47(42.6% male) RA patients with RA-ILD and a control group of 387 (17.8% male) patients without RA-ILD were included in analysis. After the median of 12 (9-19) months follow-up, mean FEV1%; 82.1 vs. 82.8 (pre/post-treatment, respectively, p=0.08), mean FVC%; 79.8 vs. 82.8 (pre/post-treatment, respectively, p=0.014) were stable and worsening was observed in 2/18 (11.1%) patients. Retention rates were similar (p=0.21, log-rank). In RA-ILD group, most common cause of drug discontinuation was infections (6.3 vs. 2.4 per 100 patient-years).
CONCLUSIONS:
Treatment strategy of RA-ILD patients is still based on small observational studies. A high rate of discontinuation due to infections was observed in RA-ILD patients under tofacitinib; however, RA-ILD patients were older than RA patients without ILD.

DOI: https://doi.org/10.55563/clinexprheumatol/9h6dtb

Rheumatology Article