INTERSTITIAL LUNG DISEASE IN PATIENTS WITH RHEUMATOID OR PSORIATIC ARTHRITIS STARTING BDMARDS: INCIDENCE VS GENERAL POPULATION, AND THE ROLE OF METHOTREXATE CO-MEDICATION
Abstract: OP0006
Authors: Aarrestad Provan S et al.
Key content:
There are few studies addressing the question whether or not PsA patients have an increased risk for ILD compared to RA patients or the general population. Patients with RA or PsA that started a new b/tsDMARD from 5 Nordic registries were included in the analysis. Data from gender and age-matched general population individuals were available from four countries. Subjects with a previous history of ILD were excluded from the analysis. The incidence of ILD was assessed through linkage to other national registries. Each patient was followed from start of b/tsDMARD until the first ILD event, death or a follow-up time period of five years. Etanercept was used as a reference.
A total of 300, 30 and 400 ILD cases developed in 37.010 patients with RA, 12.341 patients with PsA and 569.451 general population subjects. RA and PsA patients showed an increased risk for ILD compared to the general population (HR for ILD (vs. general population) was 10.1 (95% CI 8.6 to 11.9) for RA and 5.0 (3.4 to 7.4) for PsA patients initiating a b/tsDMARD.
69.608 and 21.340 treatment courses with b/ts DMARDs were identified in RA and PsA pa-tients with 558 and 46 ILD events during follow-up. Specific b/tsDMARD were not associated with an increased ILD risk in patients with PsA. 51.3% of PsA patients were on MTX co-medi-cation that did not result in an increased risk of ILD (similar to RA) compared to no use of MTX comedication.
Relevance:
Interestingly, PsA patients show a higher risk of ILD compared to the general population-whether this represents a comorbidity or a disease manifestation has to remain open at present. No data is provided on its dynamics, specific HR CT pattern or severity. However, it is reassuring that no specific association to either MTX or the use of b/ts DMARDs could be detected.
