Skip to main content
ACR Convergence 2025 Main banner
Final Program


Schedule at a Glance
Legend
Presentation Icons
CME
CME
Non-CME
Non-CME
In Person
In Person
On Demand
On Demand
Live Stream
Live Stream
Active Learning
Active Learning
Choose Rheum
Choose Rheum
Emerging Investigator Awardee
Emerging Investigator Awardee

Poster Session

Periodic Fever Syndromes, Autoinflammatory Diseases, Still’s Disease and MAS/HLH

Poster Session C

Session: (2015–2051) Miscellaneous Rheumatic & Inflammatory Diseases Poster III

2016: Effectiveness of Nintedanib combined with different DMARDs in joint and pulmonary domains of Rheumatoid Arthritis - Interstitial Lung Disease. National multicenter study of 74 patients

Tuesday, October 28, 2025
10:30 AM - 12:30 PM Central Time
Location: Hall F1
Table. Main general clinical features of RA-ILD patients at nintedanib initiation.

Figure. Evolution of pulmonary function in 74 patients with RA-ILD according to the combination of nintedanib with only biologic or only synthetic DMARDs.

    Abstract Poster Presenter(s)

  • AS

    Ana Serrano-Combarro, MD

    Division of Rheumatology, Hospital Universitario Marques de Valdecilla, IDIVAL, Inmunopathology group, Santander
    Santander, Spain

    Disclosure information not submitted.


Background/Purpose: Interstitial lung disease (ILD) is a severe complication of rheumatoid arthritis (RA) and its management remains a challenge. Approximately one third of the patients may develop a progressive ILD or show persistent inflammatory joint activity despite of disease-modifying antirheumatic drugs (DMARDs). Favorable results with the antifibrotic nintedanib (NINTE) in RA-ILD patients with pulmonary progressive fibrosis (PPF) in pulmonary function had been reported. However, data on articular response is limited, although NINTE seems to have no efficacy on the articular domain. Therefore, NINTE should be administered combined with DMARDs. Our objective was to assess the evolution of joint and pulmonary outcomes in RA-ILD patients with PPF treated of NINTE and DMARDs in clinical practice.

Methods: National Spanish multicenter study of RA-ILD patients treated with NINTE due to PPF. the main outcome measures were joint activity and forced vital capacity (FVC) evolution of different groups of treatment according to DMARDs category (biological [bDMARDs] or synthetic [sDMARDs]) were the main outcome measures.

Results: A total of 74 patients (43 men/31 women) were collected, mean age of 69±9 years. Median [IQR] ILD duration up to antifibrotic initiation was 51 [22-78] months.

NINTE was used a) combined with bDMARDs (n=47, 33 abatacept, 10 rituximab); b) combined with sDMARDs (n=29, 7 leflunomide, 6 methotrexate, 4 JAK inhibitor, 8 mycophenolate, 2 hydroxychloroquine, 1 azathioprine and 1 cyclophosphamide); c) combined with both bDMARDs and sDMARDs (n=9); and d) monotherapy (only glucocorticoids) (n=13).

To avoid interference, we select only those who are on either biological or synthetic DMARDs. Main baseline characteristics of patients are shown in Table. After 12 months of follow-up, joint activity was controlled in 81% of patients (87% in the group of NINTE+ only bDMARDs and 83% in the group of NINTE+ only sDMARDs, p=0.82). In addition, no significant decline in mean FVC or DLCO values was observed, with no statistically significant differences between the 2 groups of treatment (Figure).

Conclusion: In our series of RA-ILD patients with PPF treated with NINTE, articular inflammation could be managed either with bDMARDs or sDMARDs, with similar pulmonary function evolution.