Effectiveness and Safety of Antifibrotic Treatment in Pulmonary Fibrosis Associated with Rheumatoid Arthritis
DOI:
https://doi.org/10.12775/QS.2024.17.52930Keywords
rheumatoid arthritis, interstitial lung disease, antifibrotic treatment, RA-ILD, pulmonary fibrosisAbstract
Introduction and Objective.
Rheumatoid arthritis (RA) stands as a chronic, systemic autoimmune inflammatory ailment. Lung involvement is one of the most common extra-articular manifestations of RA. Rheumatoid Arthritis-Associated Interstitial Lung Disease (RA-ILD) is a severe, progressive disease leading to pulmonary fibrosis, characterized by deterioration of lung function, exacerbation of symptoms and typical radiological features, and early mortality.
Review methods and materials
This review utilized PubMed, Mendeley by using search terms such as pulmonary fibrosis in rheumatoid arthritis nintedanib treatment, and pulmonary fibrosis in rheumatoid arthritis pirfenidone treatment. All searches were verified by humans, duplicated results and unreliable have been rejected. In addition, case reports and previously established literature reviews were excluded from the review. We used all available original studies evaluating and comparing the efficacy and safety of anti-fibrotic drugs to create this review.
Brief description of the state of knowledge
In this review, we discuss therapeutic strategies for antifibrotic treatment involving nintedanib and pirfenidone. Furthermore, we compare the efficacy of both drugs, their influence on the extension of life, their safety profiles, and associated side effects based on research findings, and discuss the molecular mechanisms of their action.
Summary
Clinical trials concerning RA-ILD showed that nintedanib and pirfenidone slow the rate of FVC decline in patients with RA-ILD. The safety profile observed in both drugs was similar simultaneously occurring mainly gastrointestinal symptoms. Both drugs have been approved for the RA-ILD treatment program, nevertheless in the current body of knowledge, it is not feasible to definitively determine which drug therapy should be initiated first, as their characteristics are notably similar.
References
Smolen JS, Aletaha D, McInnes IB. Rheumatoid arthritis. Lancet. 2016 Oct 22;388(10055):2023-2038. hppts://doi.org/10.1016/S0140-6736(16)30173-8.
Pan J, Zou YW, Zhu YY, et al. Muscle mass loss is associated with physical dysfunction in patients with early rheumatoid arthritis. Front Nutr. 2022 Nov 23;9:1007184. https://doi.org/10.3389/fnut.2022.1007184.
Figus FA, Piga M, Azzolin I, et al. Rheumatoid arthritis: Extra-articular manifestations and comorbidities. Autoimmun Rev. 2021 Apr;20(4):102776. https://doi.org/10.1016/j.autrev.2021.102776.
Kadura S, Raghu G. Rheumatoid arthritis-interstitial lung disease: manifestations and current concepts in pathogenesis and management. Eur Respir Rev. 2021 Jun 23;30(160):210011. https://doi.org/10.1183/16000617.0011-2021.
Samy N, Salah H, Hammoda RM. Rheumatoid arthritis patients with interstitial lung disease: Clinical, radiological and laboratory characteristics. Egypt Rheumatol. September 2020 Egyptian Rheumatologist, 43(1), 29–34. https://doi.org/10.1016/j.ejr.2020.08.004.
Doyle TJ, Lee JS, Dellaripa PF, at al. A Roadmap to Promote Clinical and Translational Research in Rheumatoid Arthritis- Associated Interstitial Lung Disease. Chest 2014;145(3):454–63. https://doi.org/10.1378/chest.13-2408
Hyldgaard C, Hilberg O, Pedersen AB, et al. A population-based cohort study of rheumatoid arthritis-associated interstitial lung disease: comorbidity and mortality. Ann Rheum Dis. 2017 Oct;76(10):1700-1706. https://doi.org/10.1136/annrheumdis-2017-211138
Matteson EL, Aringer M, Burmester GR, et al. Effect of nintedanib in patients with progressive pulmonary fibrosis associated with rheumatoid arthritis: data from the INBUILD trial. Clin Rheumatol. 2023 Sep;42(9):2311-2319. https://doi.org/10.1007/s10067-023-06623-7
Zhang M, Yin J, Zhang X. Factors associated with interstitial lung disease in patients with rheumatoid arthritis: A systematic review and meta-analysis. PLoS One. 2023 Jun 23;18(6):e0286191. https://doi.org/10.1371/journal.pone.0286191
Juge P, Borie R, Kannengiesser C, et al. Shared genetic predisposition in rheumatoid arthritis-interstitial lung disease and familial pulmonary fibrosis. Eur Respir J. 2017 May 11;49(5):1602314. https://doi.org/10.1183/13993003.02314-2016
Juge P, Lee J, Ebstein E et al. MUC5B promoter variant and rheumatoid arthritis with interstitial lung disease. N Engl J Med. 2018 Dec 6;379(23):2209-2219. https://doi.org/10.1056/nejmoa1801562.
Dai Y, Wang W, Yu Y, et al. Rheumatoid arthritis-associated interstitial lung disease: an overview of epidemiology, pathogenesis and management. Clin Rheumatol. 2021 Apr;40(4):1211-1220. https://doi.org/10.1007/s10067-020-05320-z.
Matsuo T, Hashimoto M, Ito I, et al. Interleukin-18 is associated with the presence of interstitial lung disease in rheumatoid arthritis: a cross-sectional study. Scand J Rheumatol. 2019 Mar;48(2):87-94. https://doi.org/10.1080/03009742.2018.1477989
Doyle TJ, Patel AS, Hatabu H, et al. Detection of Rheumatoid Arthritis-Interstitial Lung Disease Is Enhanced by Serum Biomarkers. Am J Respir Crit Care Med. 2015 Jun 15;191(12):1403-12. https://doi.org/10.1164/rccm.201411-1950oc
Kim HJ, Swan H, Kazmi SZ, et al. Familial risk of seropositive rheumatoid arthritis and interaction with smoking: a population-based cohort study. Rheumatology (Oxford). 2023 Sep 1;62(9):3006-3013.https://doi.org/10.1093/rheumatology/kead048
Zamora-Legoff JA, Krause ML, Crowson CS, et al. Progressive Decline of Lung Function in Rheumatoid Arthritis-Associated Interstitial Lung Disease. Arthritis Rheumatol. 2017 Mar;69(3):542-549. https://doi.org/10.1002/art.39971
Adama Antczaka, Michała Myśliwca, Piotra Pruszczyka Wielka interna, Pulmonologia czesc II. (b. d.). Medical Tribune, Warszawa, 2020 rok; Chapter: Dariusz Ziora “Strategia diagnostyczna i terapeutyczna w chorobach śródmiąższowych” .p. 287-297.
Yunt ZX, Solomon JJ. Lung disease in rheumatoid arthritis. Rheum Dis Clin North Am. 2015 May;41(2):225-36. https://doi.org/10.1016/j.rdc.2014.12.004.
Lee HK, Kim DS, Yoo B,et al. Histopathologic pattern and clinical features of rheumatoid arthritis-associated interstitial lung disease. Chest. 2005 Jun;127(6):2019-27. https://doi.org/10.1378/chest.127.6.2019
Raimundo K, Solomon JJ, Olson AL, et al. Rheumatoid Arthritis-Interstitial Lung Disease in the United States: Prevalence, Incidence, and Healthcare Costs and Mortality. J Rheumatol. 2019 Apr;46(4):360-369. https://doi.org/10.3899/jrheum.171315
Sperandeo M, Muscarella S, Sperandeo G et al. Transthoracic ultrasound in the evaluation of pulmonary fibrosis – our experience. Ultraschall Med 2008; 29 - OP_13_1. https://doi.org/10.1055/s-2008-1079978
Biederer J, Schnabel A, Muhle C, et al. Correlation between HRCT findings, pulmonary function tests and bronchoalveolar lavage cytology in interstitial lung disease associated with rheumatoid arthritis. Eur Radiol. 2004 Feb;14(2):272-80. https://doi.org/10.1007/s00330-003-2026-1
Johnson S, Bernstein E, Bolster M, et al. American College of Rheumatology (ACR) Guideline for the Treatment of Interstitial Lung Disease in People with Systemic Autoimmune Rheumatic Disease. https://rheumatology.org/press-releases/acr-introduces-new-guidelines-to-screen-monitor-and-treat-interstitial-lung-disease-in-patients-with-rheumatic-conditions (access: 2023.08.22)
Wollin L, Distler J, Redente E, et al. Potential of nintedanib in treatment of progressive fibrosing interstitial lung diseases. Eur Respir J. 2019 Sep 19;54(3):1900161. https://doi.org/10.1183/13993003.00161-2019
Manfredi A, Venerito V, Cazzato M, et al. POS1053 Prevalence Of Fibrosing Progressive Interstitial Lung Disease In Rheumatoid Arthritis Patients. Ann Rheum Dis. 2023; 82(Suppl 1): 845–846. https://doi.org/10.1136/annrheumdis-2023-eular.4902.
Serra Gaspar Silva AJ, Martins A, Campinho Ferreira C, et al. POS1307 Nintedanib In Rheumatic Disease-Associated Interstitial Lung Disease – A Multicentre Nationwide Cohort Study. Ann Rheum Dis. 2023; 82(Suppl 1): 1001–1002. https://doi.org/10.1136/annrheumdis-2023-eular.4816
Redente E, Aguilar M, Black B et al. Nintedanib reduces pulmonary fibrosis in a model of rheumatoid arthritis-associated interstitial lung disease. Am J Physiol Lung Cell Mol Physiol. 2018 Jun 1;314(6):L998-L1009. https://doi.org/10.1152/ajplung.00304.2017
Dixon G, Hague S, Mulholland S, et al. Real-world experience of nintedanib for progressive fibrosing interstitial lung disease in the UK. ERJ Open Res. 2024 Jan 15;10(1):00529-2023. https://doi.org/10.1183/23120541.00529-2023
Wang J, Wang X, Qi X et al. The Efficacy and Safety of Pirfenidone Combined With Immunosuppressant Therapy in Connective Tissue Disease-Associated Interstitial Lung Disease: A 24-Week Prospective Controlled Cohort Study. Front Med (Lausanne). 2022 May 12;9:871861. https://doi.org/10.3389/fmed.2022.871861.
King T, Bradford W, Castro-Bernardini S, et al. A phase 3 trial of pirfenidone in patients with idiopathic pulmonary fibrosis. N Engl J Med. 2014 May 29;370(22):2083-92. https://doi.org/10.1056/nejmoa1402582.
Maher T. Pirfenidone in idiopathic pulmonary fibrosis. Drugs Today (Barc). 2010 Jul;46(7):473-82. https://doi.org/10.1358/dot.2010.46.7.1488336.
Solomon J, Danoff S, Woodhead F, et al. Safety, tolerability, and efficacy of pirfenidone in patients with rheumatoid arthritis-associated interstitial lung disease: a randomised, double-blind, placebo-controlled, phase 2 study. Lancet Respir Med. 2023 Jan;11(1):87-96. https://doi.org/10.1016/s2213-2600(22)00260-0.
Solomon J, Woodhead F, Danoff S, et al. A Randomized, Double-Blinded, Placebo-Controlled, Phase 2 Study Of Safety, Tolerability, And Efficacy Of Pirfenidone In Patients With Rheumatoid Arthritis Interstitial Lung Disease. Chest, 2022; 161(6): A262. https://doi.org/10.1016/j.chest.2021.12.293
Dellaripa P, Doyle T, Danoff S et al. (2021). The performance of RA disease activity and patient-reported outcomes in rheumatoid arthritis-associated interstitial lung disease in a prospective trial using pirfenidone in RA ILD (trail1). Arthritis and Rheumatology, 73(SUPPL 9), 1547–1549. Retrieved from https://doi.org/10.1002/art.41966.
Dellaripa P, Doyle T, Danoff S, et al. The performance of RA disease activity and patient-reported outcomes in rheumatoid arthritis-associated interstitial lung disease in a prospective trial using pirfenidone in RA ILD (trail1). Arthritis and Rheumatology 2021; 73(SUPPL 9), 1547–1549. http://dx.doi.org/10.1002/art.41966
Juge P, Hayashi K, McDermott G, et al. Effectiveness and tolerability of antifibrotics in rheumatoid arthritis-associated interstitial lung disease. Semin Arthritis Rheum. 2024 Feb;64:152312. https://doi.org/10.1016/j.semarthrit.2023.15231
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