{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T23:39:47Z","timestamp":1785886787485,"version":"3.56.0"},"reference-count":40,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2020,1,19]],"date-time":"2020-01-19T00:00:00Z","timestamp":1579392000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Treatment of rheumatoid arthritis (RA)-related interstitial lung disease (ILD) is challenging, and many conventional and biologic disease-modifying anti-rheumatic drugs (DMARDs) have been associated with ILD development or progression. The aim of this multicentric retrospective study was to analyze the evolution of ILD in Italian RA-ILD patients treated with abatacept (ABA). Methods: All RA-ILD patients treated with ABA for at least six months were retrospectively evaluated. Serology, previous and concurrent therapies, chest high-resolution computer tomography (HRCT), forced vital capacity (FVC), and lung diffusion of carbon monoxide (CO, DLCO) were collected. Results: Forty-four patients were included; HRCT, FVC, and DLCO were analyzed at baseline, at one year, and at the end of follow-up. A remission or a low disease activity of RA was reached in 41\/44 patients. Overall, FVC and DLCO remained stable or increased in 86.1% and 91.7% of patients, respectively, while HRCT was stable or improved in 81.4% of them. Previous and concurrent treatments, in particular, methotrexate, serology, age, sex, joint and lung disease duration were not associated with the outcome at univariate analysis. Conclusion: The management of RA-ILD patients remains a critical unmet medical need. Waiting for prospective controlled studies, ABA has shown a good safety profile in our cohort of Italian RA-ILD patients.<\/jats:p>","DOI":"10.3390\/jcm9010277","type":"journal-article","created":{"date-parts":[[2020,1,21]],"date-time":"2020-01-21T03:04:43Z","timestamp":1579575883000},"page":"277","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":64,"title":["Safety of Abatacept in Italian Patients with Rheumatoid Arthritis and Interstitial Lung Disease: A Multicenter Retrospective Study"],"prefix":"10.3390","volume":"9","author":[{"given":"Giulia","family":"Cassone","sequence":"first","affiliation":[{"name":"Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, 41121 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreina","family":"Manfredi","sequence":"additional","affiliation":[{"name":"Chair and Rheumatology Unit, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria Policlinico di Modena, 41121 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabiola","family":"Atzeni","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, University of Messina, 98121 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2573-5930","authenticated-orcid":false,"given":"Vincenzo","family":"Venerito","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, Interdisciplinary Department of Medicine, University of Bari, 70121 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caterina","family":"Vacchi","sequence":"additional","affiliation":[{"name":"Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, 41121 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Picerno","sequence":"additional","affiliation":[{"name":"Rheumatology Institute of Lucania (IReL) and Rheumatology Department of Lucania, San Carlo Hospital of Potenza and Madonna delle Grazie Hospital of Matera, 85100 Potenza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Furini","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences, Division of Rheumatology, Santa Anna University Hospital, 44100 Ferrara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6818-7666","authenticated-orcid":false,"given":"Gian Luca","family":"Erre","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, Azienda Ospedaliero-Universitaria di Sassari, 07010 Sassari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Tomietto","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, Rheumatology Unit, Azienda Sanitaria Universitaria Integrata di Trieste, 34121 Trieste, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Laura","family":"Fedele","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, Policlinico Gemelli Foundation, Catholic University of the Sacred Heart, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Della Casa","sequence":"additional","affiliation":[{"name":"Radiology Unit, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria Policlinico di Modena, 41121 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeria","family":"Nucera","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, University of Messina, 98121 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Giannitti","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, University of Siena, 53011 Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Salvarani","sequence":"additional","affiliation":[{"name":"Chair and Rheumatology Unit, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria Policlinico di Modena, 41121 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1294-6421","authenticated-orcid":false,"given":"Marco","family":"Sebastiani","sequence":"additional","affiliation":[{"name":"Chair and Rheumatology Unit, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria Policlinico di Modena, 41121 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,1,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2023","DOI":"10.1016\/S0140-6736(16)30173-8","article-title":"Rheumatoid arthritis","volume":"22","author":"Smolen","year":"2016","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1544","DOI":"10.1002\/art.40574","article-title":"The Lung in Rheumatoid Arthritis: Focus on Interstitial Lung Disease","volume":"70","author":"Spagnolo","year":"2018","journal-title":"Arthritis Rheumatol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1583","DOI":"10.1002\/art.27405","article-title":"Incidence and mortality of interstitial lung disease in rheumatoid arthritis: A population-based study","volume":"62","author":"Bongartz","year":"2010","journal-title":"Arthritis Rheum."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1164\/rccm.201004-0622OC","article-title":"Rheumatoid arthritis-interstitial lung disease-associated mortality","volume":"183","author":"Olson","year":"2011","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"360","DOI":"10.3899\/jrheum.171315","article-title":"Rheumatoid Arthritis-Interstitial Lung Disease in the United States: Prevalence, Incidence, and Healthcare Costs and Mortality","volume":"46","author":"Raimundo","year":"2019","journal-title":"J. Rheumatol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1700","DOI":"10.1136\/annrheumdis-2017-211138","article-title":"A population-based cohort study of rheumatoid arthritis-associated interstitial lung disease: Comorbidity and mortality","volume":"76","author":"Hyldgaard","year":"2017","journal-title":"Ann. Rheum. Dis."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1097\/BOR.0000000000000238","article-title":"The lung in rheumatoid arthritis, cause or consequence?","volume":"28","author":"Chatzidionisyou","year":"2016","journal-title":"Curr. Opin. Rheumatol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1016\/j.semarthrit.2013.09.005","article-title":"Interstitial lung diseases induced or exacerbated by DMARDS and biologic agents in rheumatoid arthritis: A systematic literature review","volume":"43","author":"Roubille","year":"2014","journal-title":"Semin. Arthritis Rheum."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1038\/nrrheum.2013.197","article-title":"The safety of biologic therapies in RA-associated interstitial lung disease","volume":"10","author":"Jani","year":"2014","journal-title":"Nat. Rev. Rheumatol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"146","DOI":"10.5152\/eurjrheum.2019.19036","article-title":"Comprehensive review of current diagnostic and treatment approaches to interstitial lung disease associated with rheumatoid arthritis","volume":"6","author":"Bes","year":"2018","journal-title":"Eur. J. Rheumatol."},{"key":"ref_11","first-page":"235","article-title":"Practical Approach to the Evaluation and Management of Rheumatoid Arthritis-Interstitial Lung Disease Based on its Proven and Hypothetical Mechanisms","volume":"69","author":"Paulin","year":"2017","journal-title":"Rev. Investig. Clin."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1097\/MCP.0000000000000600","article-title":"New trajectories in the treatment of interstitial lung disease: Treat the disease or treat the underlying pattern?","volume":"25","author":"Morisset","year":"2019","journal-title":"Curr. Opin. Pulm. Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"960","DOI":"10.1136\/annrheumdis-2016-210715","article-title":"EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2016 update","volume":"76","author":"Smolen","year":"2017","journal-title":"Ann. Rheum. Dis."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1221","DOI":"10.1007\/s40265-017-0775-4","article-title":"Abatacept: A Review in Rheumatoid Arthritis","volume":"77","author":"Blair","year":"2017","journal-title":"Drugs"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1186\/s13075-018-1694-9","article-title":"T-cell costimulation blockade is effective in experimental digestive and lung tissue fibrosis","volume":"20","author":"Boleto","year":"2018","journal-title":"Arthritis Res. Ther."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1016\/j.yexmp.2011.09.010","article-title":"The effect of CTLA-4Ig, a CD28\/B7 antagonist, on the lung inflammation and T cell subset profile during murine hypersensitivity pneumonitis","volume":"91","author":"Arreola","year":"2011","journal-title":"Exp. Mol. Pathol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1097\/RHU.0000000000000084","article-title":"Abatacept therapy in rheumatoid arthritis with interstitial lung disease","volume":"20","year":"2014","journal-title":"J. Clin. Rheumatol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1097\/RHU.0000000000000481","article-title":"Refractory Rheumatoid Arthritis and Associated Interstitial Lung Disease: Could Abatacept be the Answer?","volume":"23","author":"Ye","year":"2017","journal-title":"J. Clin. Rheumatol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1016\/j.resinv.2016.03.001","article-title":"Possible effect of abatacept on the progression of interstitial lung disease in rheumatoid arthritis patients","volume":"54","author":"Nakashita","year":"2016","journal-title":"Respir. Investig."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1186\/s13075-015-0835-7","article-title":"Incidence and complications of interstitial lung disease in users of tocilizumab, rituximab, abatacept and anti-tumor necrosis factor \u03b1 agents, a retrospective cohort study","volume":"17","author":"Curtis","year":"2015","journal-title":"Arthritis Res. Ther."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1016\/j.semarthrit.2017.12.012","article-title":"Abatacept in patients with rheumatoid arthritis and interstitial lung disease: A national multicenter study of 63 patients","volume":"48","author":"Loricera","year":"2018","journal-title":"Semin. Arthritis Rheum."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1080\/14397595.2018.1481566","article-title":"Long-term deterioration of interstitial lung disease in patients with rheumatoid arthritis treated with abatacept","volume":"29","author":"Mochizuki","year":"2018","journal-title":"Mod. Rheumatol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1002\/art.1780310302","article-title":"The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis","volume":"31","author":"Arnett","year":"1988","journal-title":"Arthritis Rheum."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"2569","DOI":"10.1002\/art.27584","article-title":"2010 rheumatoid arthritis classification criteria: An American College of Rheumatology\/European League Against Rheumatism collaborative initiative","volume":"62","author":"Aletaha","year":"2010","journal-title":"Arthritis Rheum."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"733","DOI":"10.1164\/rccm.201308-1483ST","article-title":"ATS\/ERS Committee on Idiopathic Interstitial Pneumonias; ATS\/ERS Committee on Idiopathic Interstitial Pneumonias. An official American Thoracic Society\/European Respiratory Society statement: Update of the international multidisciplinary classification of the idiopathic interstitial pneumonias","volume":"188","author":"Travis","year":"2013","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1136\/thoraxjnl-2013-203843","article-title":"Connective tissue disease related fibrotic lung disease: High resolution computed tomographic and pulmonary function indices as prognostic determinants","volume":"69","author":"Walsh","year":"2014","journal-title":"Thorax"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1189","DOI":"10.1056\/NEJMp1500526","article-title":"Forced vital capacity in idiopathic pulmonary fibrosis\u2014FDA review of pirfenidone and nintedanib","volume":"372","author":"Chowdhury","year":"2015","journal-title":"N. Engl. J. Med."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Altman, D.G. (1991). Practical Statistics for Medical Research, Chapman and Hall. [1st ed.].","DOI":"10.1201\/9780429258589"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"433","DOI":"10.2177\/jsci.35.433","article-title":"A case of rheumatoid arthritis complicated with deteriorated interstitial pneumonia after the administration of abatacept","volume":"35","author":"Wada","year":"2012","journal-title":"Nihon Rinsho Meneki Gakkai Kaishi"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e005615","DOI":"10.1136\/bmjopen-2014-005615","article-title":"Potential risk of TNF inhibitors on the progression of interstitial lung disease in patients with rheumatoid arthritis","volume":"4","author":"Nakashita","year":"2014","journal-title":"BMJ Open"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1703","DOI":"10.2169\/internalmedicine.2226-18","article-title":"Effect of Biological Disease-modifying Anti-rheumatic Drugs on Airway and Interstitial Lung Disease in Patients with Rheumatoid Arthritis","volume":"15","author":"Kurata","year":"2019","journal-title":"Intern. Med."},{"key":"ref_32","unstructured":"(2019, December 30). Clinicaltrials.gov, Available online: https:\/\/clinicaltrials.gov\/ct2\/show\/NCT03084419."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"238","DOI":"10.3389\/fmed.2019.00238","article-title":"Methotrexate-Associated Pneumonitis and Rheumatoid Arthritis-Interstitial Lung Disease: Current Concepts for the Diagnosis and Treatment","volume":"6","author":"Fragoulis","year":"2019","journal-title":"Front. Med. (Lausanne)"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"e028466","DOI":"10.1136\/bmjopen-2018-028466","article-title":"Is incident rheumatoid arthritis interstitial lung disease associated with methotrexate treatment? Results from a multivariate analysis in the ERAS and ERAN inception cohorts","volume":"9","author":"Kiely","year":"2019","journal-title":"BMJ Open"},{"key":"ref_35","first-page":"542","article-title":"Interstitial lung disease is associated to infections of lower respiratory tract in immunocompromised rheumatoid arthritis patients","volume":"35","author":"Sebastiani","year":"2017","journal-title":"Clin. Exp. Rheumatol."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Manfredi, A., Cassone, G., Furini, F., Gremese, E., Venerito, V., Atzeni, F., Arrigoni, E., Della Casa, G., Cerri, S., and Govoni, M. (2019). Tocilizumab therapy in rheumatoid arthritis with interstitial lung disease: A multicenter retrospective study. Intern. Med. J., 29.","DOI":"10.1111\/imj.14670"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1177\/1753465816668780","article-title":"Therapeutic management of patients with rheumatoid arthritis and associated interstitial lung disease: Case report and literature review","volume":"11","author":"Markovic","year":"2017","journal-title":"Ther. Adv Respir. Dis."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1007\/s40744-018-0097-3","article-title":"Worldwide, 3-Year, Post-Marketing Surveillance Experience with Tofacitinib in Rheumatoid Arthritis","volume":"5","author":"Cohen","year":"2018","journal-title":"Rheumatol. Ther."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"e000491","DOI":"10.1136\/rmdopen-2017-000491","article-title":"Safety and maintenance of response for tofacitinib monotherapy and combination therapy in rheumatoid arthritis: An analysis of pooled data from open-label long-term extension studies","volume":"3","author":"Fleischmann","year":"2017","journal-title":"RMD Open"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Manfredi, A., Cassone, G., Cerri, S., Venerito, V., Fedele, A.L., Trevisani, M., Furini, F., Addimanda, O., Pancaldi, F., and Della Casa, G. (2019). Diagnostic accuracy of a velcro sound detector (VECTOR) for interstitial lung disease in rheumatoid arthritis patients: The InSPIRAtE validation study (INterStitial pneumonia in rheumatoid ArThritis with an electronic device). BMC Pulm. Med., 19.","DOI":"10.1186\/s12890-019-0875-x"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/9\/1\/277\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T13:20:14Z","timestamp":1760361614000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/9\/1\/277"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1,19]]},"references-count":40,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2020,1]]}},"alternative-id":["jcm9010277"],"URL":"https:\/\/doi.org\/10.3390\/jcm9010277","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,1,19]]}}}