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• W4379650074 abstract "Background Interstitial lung disease (ILD) is the most frequent non-pleural pulmonary manifestation in rheumatoid arthritis (RA) and causes high morbidity and mortality [1-3]. Currently, there are no clinically useful serum markers for the diagnosis and prognosis of RA associated ILD (RA-ILD) [4]. Objectives To identify soluble cytokines that work as biomarkers for diagnosis and prognosis in RA-ILD and explore whether there is an association between those and pulmonary progression. Methods Observational case-control study nested in a prospective cohort of cases of patients with RA (ACR/EULAR 2010) [5] with and without ILD, paired by sex, age, and time of RA evolution. All subjects underwent pulmonary function tests (PFTs) and high-resolution computed tomography (HRCT) on the inclusion date (protocol date) and, in cases of RA-ILD, also on diagnosis of ILD. The primary variable ILD was defined according to lung biopsy or HRCT according to the American Thoracic Society/European Respiratory Criteria [6], and pulmonary progression was defined as worsening FVC >10% or DLCO >15% [4]. Inflammation variables included inflammatory activity data measured by DAS28-ESR and a cytokine multiplex including Th1/Th2 function, inflammatory cytokines, and chemokines. Other clinical, RA severity and therapeutic variables were also studied: rheumatoid factors (RF), anti-cyclic citrullinated peptide antibodies (ACPA), radiological erosions, and Health Assessment Questionnaire (HAQ) values. A descriptive analysis and two Cox regression models were performed to identify factors associated with ILD and ILD progression in RA, adjusting for time to development of ILD-RA and to ILD progression, respectively. Results A total of 70 subjects were included, 35 RA-ILD cases and 35 RA controls without ILD (Table 1). A higher percentage of patients with RA-ILD, compared to the rest, presented elevated RF (p=0.089) and ACPA levels (p=0.031), higher DAS28-ESR values (p=0.032), number of swollen joints (p=0.040) and worse quality of life measured by HAQ (p=0.003). The variables that were independently associated with RA-ILD in the Cox regression adjusted for time of evolution of RA (Figure 1) were DAS28-ESR of moderate-high activity (OR [95% CI], 2,474 [1,173-5,220]; p= 0.017), elevated ACPA levels (OR [95% CI], 2.905 [1.244-6.786]; p=0.014), IL-18 (OR [95% CI], 1.063 [1.002-1.127]; p=0.044), MCP1CCL2 (OR [95% CI], 1.031 [1.001-1.064]; p=0.049) and SDF1 (OR [95% CI], 1.001 [1.001-1.002]; p=0.010). In the other COX regression model adjusted for time to ILD progression, the only variable associated with progression was IL18 (OR [95% CI], 1.254 [1.074-1.465]; p=0.004). Table 1. Baseline characteristics of the study population VARIABLE RA-ILD n=35 RA without ILD n=35 P -value RF+ (>10), n (% ) 33 (94.3) 31 (88.6) 0.393 High RF (>60 ) 24 (68.6) 17 (48.6) 0.089 ACPA+ (>20), n (% ) 32 (91.4) 31 (88.6) 0.690 High ACPA (>340), n (% ) 22 (63.0) 14 (40.0) 0.039 Erosions, n (% ) 21 (60.0) 19 (55.6) 0.705 DAS28-ESR, mean (SD ) 3.1 (0.9) 2.6 (0.9) 0.032 Remission/low activity, n (% ) 19 (54.3) 27 (77.1) 0.044 Moderate/high activity, n (% ) 16 (45.7) 8 (22.9) 0.044 Number of swollen joints, median (IQR ) 0.0 (0.0-1.0) 0.0 (0.0-0.0) 0.040 HAQ, mean (SD ) 1.2 (0.6) 0.8 (0.6) 0.003 Figure 1. Cox regression analysis adjusted for time of evolution of RA Conclusion Patients with RA-ILD show higher inflammatory activity than RA patients without ILD. Some cytokines are associated both with diagnosis and with a worse prognosis in patients with RA-ILD, so they could be potential biomarkers for this entity. Future studies are needed to validate these data and confirm the findings. References [1] Aguilar-Hurtado MC, et al. J Clin Med. 2021 Feb;10(4) [2] Castellví I, et al. Reumatol Clin. 2022 Sep [3] Fischer A, et al. Eur Respir J. 2016 Feb;47(2):588–96 [4] Nieto MA, et al. Reumatol Clin. 2022 Oct;18(8):443–52 [5] Aggarwal R, et al. Arthritis Rheum. 2010 Sep;62(9):2582–91 [6] Lederer DJ, et al. Am J Respir Crit Care Med. 2018 Sep;198(5):e44–68 Acknowledgements This work was supported by Youth Guarantee Aid 2020 (UMA, SNGJ5Y6–12) and PAIDI Study Group for Inflammatory Rheumatic Diseases (CTS-1034) Disclosure of Interests None Declared." @default.
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• W4379650074 date "2023-05-30" @default.
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• W4379650074 title "POS1056 CYTOKINE ANALYSIS IN PATIENTS WITH INTERSTITIAL LUNG DISEASE ASSOCIATED WITH RHEUMATOID ARTHRITIS" @default.
• W4379650074 doi "https://doi.org/10.1136/annrheumdis-2023-eular.2217" @default.
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