Successful Treatment of a Patient with Drug-Refractory Rheumatoid Arthritis-Associated Interstitial Lung Disease with Upadacitinib: A Case Report
Abstract
:1. Introduction
2. Case Presentation
3. Discussion
4. Conclusions
Author Contributions
Funding
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Scott, D.L.; Wolfe, F.; Huizinga, T.W. Rheumatoid arthritis. Lancet 2010, 376, 1094–1108. [Google Scholar] [CrossRef]
- Nakajima, A.E.; Inoue, E.; Tanaka, G.; Singh, E.; Sato, D.; Hoshi, K.; Shidara, M.; Hara, S.; Momohara, A.; Taniguchi, N.; et al. Mortality and cause of death in Japanese patients with rheumatoid arthritis based on a large observational cohort, IORRA. Scand. J. Rheumatol. 2010, 39, 360–367. [Google Scholar] [CrossRef] [PubMed]
- Kim, H.; Cho, S.K.; Song, Y.J.; Kang, J.; Jeong, S.A.; Kim, H.W.; Choi, C.B.; Kim, T.H.; Jun, J.B.; Bae, S.C.; et al. Clinical characteristics of rheumatoid arthritis patients with interstitial lung disease: Baseline data of a single-center prospective cohort. Arthritis Res. Ther. 2023, 25, 43. [Google Scholar] [CrossRef]
- Salaffi, F.; Carotti, M.; Di Carlo, M.; Tardella, M.; Giovagnoni, A. High-resolution computed tomography of the lung in patients with rheumatoid arthritis: Prevalence of interstitial lung disease involvement and determinants of abnormalities. Medicine 2019, 98, e17088. [Google Scholar] [CrossRef] [PubMed]
- Bongartz, T.; Nannini, C.; Medina-Velasquez, Y.F.; Achenbach, S.J.; Crowson, C.S.; Ryu, J.H.; Vassallo, R.; Gabriel, S.E.; Matteson, E.L. Incidence and mortality of interstitial lung disease in rheumatoid arthritis: A population-based study. Arthritis Rheum. 2010, 62, 1583–1591. [Google Scholar] [CrossRef] [PubMed]
- Koduri, G.; Norton, S.; Young, A.; Cox, N.; Davies, P.; Devlin, J.; Dixey, J.; Gough, A.; Prouse, P.; Winfield, J.; et al. Interstitial lung disease has a poor prognosis in rheumatoid arthritis: Results from an inception cohort. Rheumatology 2010, 49, 1483–1489. [Google Scholar] [CrossRef]
- Kondoh, Y.; Makino, S.; Ogura, T.; Suda, T.; Tomioka, H.; Amano, H.; Anraku, M.; Enomoto, N.; Fujii, T.; Fujisawa, T.; et al. 2020 guide for the diagnosis and treatment of interstitial lung disease associated with connective tissue disease. Respir. Investig. 2021, 59, 709–740. [Google Scholar] [CrossRef]
- Assayag, D.; Lee, J.S.; King, T.E., Jr. Rheumatoid arthritis associated interstitial lung disease: A review. Medicina 2014, 74, 158–165. [Google Scholar]
- Yamakawa, H.; Ogura, T.; Kameda, H.; Kishaba, T.; Iwasawa, T.; Takemura, T.; Kuwano, K. Decision-Making Strategy for the Treatment of Rheumatoid Arthritis-Associated Interstitial Lung Disease (RA-ILD). J. Clin. Med. 2021, 10, 3806. [Google Scholar] [CrossRef]
- Cassone, G.; Manfredi, A.; Vacchi, C.; Luppi, F.; Coppi, F.; Salvarani, C.; Sebastiani, M. Treatment of Rheumatoid Arthritis-Associated Interstitial Lung Disease: Lights and Shadows. J. Clin. Med. 2020, 9, 1082. [Google Scholar] [CrossRef]
- Fraenkel, L.; Bathon, J.M.; England, B.R.; St Clair, E.W.; Arayssi, T.; Carandang, K.; Deane, K.D.; Genovese, M.; Huston, K.K.; Kerr, G.; et al. 2021 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis. Arthritis Care Res. 2021, 73, 924–939. [Google Scholar] [CrossRef] [PubMed]
- Yamano, Y.; Taniguchi, H.; Kondoh, Y.; Ando, M.; Kataoka, K.; Furukawa, T.; Johkoh, T.; Fukuoka, J.; Sakamoto, K.; Hasegawa, Y. Multidimensional improvement in connective tissue disease-associated interstitial lung disease: Two courses of pulse dose methylprednisolone followed by low-dose prednisone and tacrolimus. Respirology 2018, 23, 1041–1048. [Google Scholar] [CrossRef]
- Flaherty, K.R.; Wells, A.U.; Cottin, V.; Devaraj, A.; Walsh, S.L.F.; Inoue, Y.; Richeldi, L.; Kolb, M.; Tetzlaff, K.; Stowasser, S.; et al. INBUILD Trial Investigators. Nintedanib in Progressive Fibrosing Interstitial Lung Diseases. N. Engl. J. Med. 2019, 381, 1718–1727. [Google Scholar] [CrossRef] [PubMed]
- Raghu, G.; Remy-Jardin, M.; Richeldi, L.; Thomson, C.C.; Inoue, Y.; Johkoh, T.; Kreuter, M.; Lynch, D.A.; Maher, T.M.; Martinez, F.J.; et al. Idiopathic Pulmonary Fibrosis (an Update) and Progressive Pulmonary Fibrosis in Adults: An Official ATS/ERS/JRS/ALAT Clinical Practice Guideline. Am. J. Respir. Crit. Care Med. 2022, 205, e18–e47. [Google Scholar] [CrossRef] [PubMed]
- Solomon, J.J.; Danoff, S.K.; Woodhead, F.A.; Hurwitz, S.; Maurer, R.; Glaspole, I.; Dellaripa, P.F.; Gooptu, B.; Vassallo, R.; Cox, P.G.; 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, 11, 87–96. [Google Scholar] [CrossRef]
- Suda, T. Up-to-date information on rheumatoid arthritis-associated interstitial lung disease. Clin. Med. Insights Circ. Respir. Pulm. Med. 2016, 9, 155–162. [Google Scholar] [CrossRef]
- Imokawa, S.; Colby, T.V.; Leslie, K.O.; Helmers, R.A. Methotrexate pneumonitid: Review of the literature and histopathological findings in nine patients. Eur. Respir. J. 2000, 15, 373–381. [Google Scholar] [CrossRef]
- Sakai, R.; Komano, Y.; Tanaka, M.; Nanki, T.; Koike, R.; Nagasawa, H.; Amano, K.; Nakajima, A.; Atsumi, T.; Koike, T.; et al. Time-dependent increased risk for serious infection from continuous use of tumor necrosis factor antagonists over three years in patients with rheumatoid arthritis. Arthritis Care Res. 2012, 64, 1125–1134. [Google Scholar]
- Juge, P.A.; Lee, J.S.; Lau, J.; Kawano-Dourado, L.; Rojas Serrano, J.; Sebastiani, M.; Koduri, G.; Matteson, E.; Bonfiglioli, K.; Sawamura, M.; et al. Methotrexate and rheumatoid arthritis associated interstitial lung disease. Eur. Respir. J. 2021, 57, 2000337. [Google Scholar] [CrossRef]
- Adegunsoye, A.; Oldham, J.M.; Bellam, S.K.; Montner, S.; Churpek, M.M.; Noth, I.; Vij, R.; Strek, M.E.; Chung, J.H. Computed tomography honeycombing identifies a progressive fibrotic phenotype with increased mortality across diverse interstitial lung diseases. Ann. Am. Thorac. Soc. 2019, 16, 580–588. [Google Scholar] [CrossRef]
- Matson, S.M.; Baqir, M.; Moua, T.; Marll, M.; Kent, J.; Iannazzo, N.S.; Boente, R.D.; Donatelli, J.M.; Dai, J.; Diaz, F.J.; et al. A Real-World, Multisite Study of the Impact of Immunosuppression on Pulmonary Function Trajectory. Chest 2023, 163, 861–869. [Google Scholar] [CrossRef] [PubMed]
- Mena-Vázquez, N.; Rojas-Gimenez, M.; Romero-Barco, C.M.; Manrique-Arija, S.; Francisco, E.; Aguilar-Hurtado, M.C.; Añón-Oñate, I.; Pérez-Albaladejo, L.; Ortega-Castro, R.; Godoy-Navarrete, F.J.; et al. Predictors of Progression and Mortality in Patients with Prevalent Rheumatoid Arthritis and Interstitial Lung Disease: A Prospective Cohort Study. J. Clin. Med. 2021, 10, 874. [Google Scholar] [CrossRef] [PubMed]
- Fernández-Díaz, C.; Castañeda, S.; Melero-González, R.B.; Ortiz-Sanjuán, F.; Juan-Mas, A.; Carrasco-Cubero, C.; Casafont-Solé, I.; Olivé, A.; Rodríguez-Muguruza, S.; Almodóvar-González, R.; et al. Association of disease activity with acute exacerbation of interstitial lung disease during tocilizumab treatment in patients with rheumatoid arthritis: A retrospective, case-control study. Rheumatol. Int. 2016, 36, 881–889. [Google Scholar]
- Maher, T.M.; Tudor, V.A.; Saunders, P.; Gibbons, M.A.; Fletcher, S.V.; Denton, C.P.; Hoyles, R.K.; Parfrey, H.; Renzoni, E.A.; Kokosi, M.; et al. Rituximab versus intravenous cyclophosphamide in patients with connective tissue disease-associated interstitial lung disease in the UK (RECITAL): A double-blind, double-dummy, randomised, controlled, phase 2b trial. Lancet Respir. Med. 2023, 11, 45–54. [Google Scholar] [CrossRef]
- Ebata, S.; Oba, K.; Kashiwabara, K.; Ueda, K.; Uemura, Y.; Watadani, T.; Fukasawa, T.; Miura, S.; Yoshizaki-Ogawa, A.; Yoshihide, A.; et al. Predictors of rituximab effect on modified Rodnan skin score in systemic sclerosis: A machine-learning analysis of the DesiReS trial. Rheumatology 2022, 61, 4364–4373. [Google Scholar] [CrossRef]
- Khanna, D.; Lin, C.J.F.; Furst, D.E.; Goldin, J.; Kim, G.; Kuwana, M.; Allanore, Y.; Matucci-Cerinic, M.; Distler, O.; Shima, Y.; et al. Tocilizumab in systemic sclerosis: A randomised, double-blind, placebo-controlled, phase 3 trial. Lancet Respir. Med. 2020, 8, 963–974. [Google Scholar] [CrossRef]
- Kubo, S.; Nakayamada, S.; Tanaka, Y. JAK inhibitors for rheumatoid arthritis. Expert. Opin. Investig. Drugs. 2023, 323, 33–344. [Google Scholar] [CrossRef]
- Huo, R.; Guo, Q.; Hu, J.; Li, N.; Gao, R.; Mi, L.; Zhang, Z.; Liu, H.; Guo, Z.; Zhao, H.; et al. Therapeutic Potential of Janus Kinase Inhibitors for the Management of Interstitial Lung Disease. Drug Des. Dev. Ther. 2022, 16, 991–998. [Google Scholar] [CrossRef]
- Ma, X.; Chen, R.; Liu, X.; Xie, J.; Si, K.; Duan, L. Effects of matrine on JAK-STAT signaling transduction pathways in bleomycin-induced pulmonary fibrosis. Afr. J. Tradit. Complement. Altern. Med. 2013, 10, 442–448. [Google Scholar] [CrossRef]
- Milara, J.; Hernandez, G.; Ballester, B.; Morell, A.; Roger, I.; Montero, P.; Escrivá, J.; Lloris, J.M.; Molina-Molina, M.; Morcillo, E.; et al. The JAK2 pathway is activated in idiopathic pulmonary fibrosis. Respir. Res. 2018, 19, 24. [Google Scholar] [CrossRef]
- Sendo, S.; Saegusa, J.; Yamada, H.; Nishimura, K.; Morinobu, A. Tofacitinib facilitates the expansion of myeloid-derived suppressor cells and ameliorates interstitial lung disease in SKG mice. Arthritis Res. Ther. 2019, 21, 184. [Google Scholar] [CrossRef] [PubMed]
- Baker, M.C.; Liu, Y.; Lu, R.; Lin, J.; Melehani, J.; Robinson, W.H. Incidence of Interstitial Lung Disease in Patients with Rheumatoid Arthritis Treated With Biologic and Targeted Synthetic Disease-Modifying Antirheumatic Drugs. JAMA Netw. Open. 2023, 6, e233640. [Google Scholar] [CrossRef] [PubMed]
- Venerito, V.; Manfredi, A.; Lopalco, G.; Lavista, M.; Cassone, G.; Scardapane, A.; Sebastiani, M.; Iannone, F. Radiomics to predict the mortality of patients with rheumatoid arthritis-associated interstitial lung disease: A proof-of-concept study. Front. Med. 2023, 9, 1069486. [Google Scholar] [CrossRef] [PubMed]
- D’Alessandro, M.; Perillo, F.; Metella Refini, R.; Bergantini, L.; Bellisai, F.; Selvi, E.; Cameli, P.; Manganelli, S.; Conticini, E.; Cantarini, L.; et al. Efficacy of baricitinib in treating rheumatoid arthritis: Modulatory effects on fibrotic and inflammatory biomarkers in a real-life setting. Int. Immunopharmacol. 2020, 86, 106748. [Google Scholar] [CrossRef] [PubMed]
- Vacchi, C.; Manfredi, A.; Cassone, G.; Cerri, S.; Della Casa, G.; Andrisani, D.; Salvarani, C.; Sebastiani, M. Tofacitinib for the Treatment of Severe Interstitial Lung Disease Related to Rheumatoid Arthritis. Case Rep. Med. 2021, 2021, 6652845. [Google Scholar] [CrossRef] [PubMed]
- Aletaha, D.; Neogi, T.; Silman, A.J.; Funovits, J.; Felson, D.T.; Bingham, C.O., 3rd; Birnbaum, N.S.; Burmester, G.R.; Bykerk, V.P.; Cohen, M.D. 2010 Rheumatoid arthritis classification criteria: An American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthritis Rheum. 2010, 62, 2569–2581. [Google Scholar] [CrossRef]
- Raghu, G.; Collard, H.R.; Egan, J.J.; Martinez, F.J.; Behr, J.; Brown, K.K.; Colby, T.V.; Cordier, J.F.; Flaherty, K.R.; Lasky, J.A.; et al. An official ATS/ERS/JRS/ALAT statement: Idiopathic pulmonary fibrosis: Evidence-based guidelines for diagnosis and management. Am. J. Respir. Crit. Care Med. 2011, 183, 788–824. [Google Scholar] [CrossRef]
- Greenmyer, J.R.; Stacy, J.M.; Sahmoun, A.E.; Beal, J.R.; Diri, E. DAS28-CRP Cutoffs for High Disease Activity and Remission Are Lower Than DAS28-ESR in Rheumatoid Arthritis. ACR Open Rheumatol. 2020, 2, 507–511. [Google Scholar] [CrossRef]
- Kurasawa, K.; Arai, S.; Namiki, Y.; Tanaka, A.; Takamura, Y.; Owada, T.; Arima, M.; Maezawa, R. Tofacitinib for refractory interstitial lung diseases in anti-melanoma differentiation-associated 5 gene antibody-positive dermatomyositis. Rheumatology 2018, 57, 2114–2119. [Google Scholar] [CrossRef]
- Hornig, J.; Weinhage, T.; Schmidt, L.H.; Buerke, B.; Schneider, U.; Pavenstädt, H.; Becker, H.; Gabriëls, G. Ansprechen einer Dermatomyositis mit Lungenbeteiligung auf eine Januskinase-Inhibitor-Therapie [Response of dermatomyositis with lung involvement to Janus kinase inhibitor treatment]. Z. Rheumatol. 2018, 77, 952–957. [Google Scholar] [CrossRef]
- Chen, Z.; Wang, X.; Ye, S. Tofacitinib in Amyopathic Dermatomyositis-Associated Interstitial Lung Disease. N. Engl. J. Med. 2019, 381, 291–293. [Google Scholar] [CrossRef] [PubMed]
- Yates, M.; Mootoo, A.; Adas, M.; Bechman, K.; Rampes, S.; Patel, V.; Qureshi, S.; Cope, A.P.; Norton, S.; Galloway, J.B. Venous Thromboembolism Risk with JAK Inhibitors: A Meta-Analysis. Arthritis Rheumatol. 2021, 73, 779–788. [Google Scholar] [CrossRef] [PubMed]
- European Medicines Agency Science Medicines Health Website. Available online: https://www.ema.europa.eu/en/medicines/human/referrals/janus-kinase-inhibitors-jaki#key-facts-section (accessed on 8 September 2023).
Complete blood count | - | CRP | 6.0 | mg/dL | |
White blood cells | 3900 | /μL | Ferritin | 389.8 | ng/mL |
Neutrophils | 39.3 | % | MMP3 | 268.9 | ng/mL |
Lymphocytes | 39.1 | % | KL-6 | 1440 | U/mL |
Eosinophils | 1.0 | % | Autoantibodies | - | - |
Hemoglobin | 12.2 | g/dL | Antinuclear antibody | 40 | Index |
Hematocrit | 38.6 | % | with homogeneous pattern | - | - |
Platelet count | 2.6 × 104 | /μL | Rheumatoid factor | 9.0 | IU/mL |
ESR | 57 | mm/h | ACPA | 0.7 | U/mL |
Laboratory data | - | - | Anti-RNP antibody | Negative | - |
Total protein | 7.5 | g/dL | Anti-Ro60 antibody | Negative | - |
Lactate dehydrogenase | 237 | IU/L | Anti-La antibody | Negative | - |
Aspartate transaminase | 21 | IU/L | Anti-topoisomerase-1 antibody | Negative | - |
Alanine transaminase | 13 | IU/L | Myeloperoxidase-ANCA | Negative | - |
Total bilirubin | 0.5 | g/dL | Proteinase-ANCA | Negative | - |
Blood Urea Nitrogen | 21 | mg/dL | Pulmonary function | - | - |
Creatinine | 0.87 | mg/dL | FVC | 111.0 | % |
Na | 139 | mEq/L | FEV1% | 88.0 | % |
K | 4.6 | mEq/L | DLCO/VA | 68.0 | % |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Nishii, Y.; Okamoto, M.; Zaizen, Y.; Kojima, T.; Nouno, T.; Naitou-Nishida, Y.; Matsuo, N.; Takeoka, H.; Ishida, M.; Nakamura, M.; et al. Successful Treatment of a Patient with Drug-Refractory Rheumatoid Arthritis-Associated Interstitial Lung Disease with Upadacitinib: A Case Report. Medicina 2023, 59, 1960. https://doi.org/10.3390/medicina59111960
Nishii Y, Okamoto M, Zaizen Y, Kojima T, Nouno T, Naitou-Nishida Y, Matsuo N, Takeoka H, Ishida M, Nakamura M, et al. Successful Treatment of a Patient with Drug-Refractory Rheumatoid Arthritis-Associated Interstitial Lung Disease with Upadacitinib: A Case Report. Medicina. 2023; 59(11):1960. https://doi.org/10.3390/medicina59111960
Chicago/Turabian StyleNishii, Yuuya, Masaki Okamoto, Yoshiaki Zaizen, Takashi Kojima, Takashi Nouno, Yoshiko Naitou-Nishida, Norikazu Matsuo, Hiroaki Takeoka, Motoko Ishida, Masataka Nakamura, and et al. 2023. "Successful Treatment of a Patient with Drug-Refractory Rheumatoid Arthritis-Associated Interstitial Lung Disease with Upadacitinib: A Case Report" Medicina 59, no. 11: 1960. https://doi.org/10.3390/medicina59111960