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Background/Aims To compare the effects of abatacept and conventional synthetic disease modifying anti-rheumatic drugs (csDMARDs) on the progression and development of rheumatoid arthritis-associated interstitial lung disease (RA-ILD). Methods This multi-center retrospective study included RA patients receiving abatacept or csDMARDs who underwent at least two pulmonary function tests and/or chest high-resolution computed tomography (HRCT). We compared the following outcomes between the groups: progression of RA-ILD, development of new ILD in RA patients without ILD at baseline, 28-joint Disease Activity Score with the erythrocyte sedimentation rate (DAS28-ESR), and safety. Longitudinal changes were compared between the groups by using a generalized estimating equation. Results The study included 123 patients who were treated with abatacept (n = 59) or csDMARDs (n = 64). Nineteen (32.2%) and 38 (59.4%) patients treated with abatacept and csDMARDs, respectively, presented with RA-ILD at baseline. Newly developed ILD occurred in one patient receiving triple csDMARDs for 32 months. Among patients with RA-ILD at baseline, ILD progressed in 21.1% of cases treated with abatacept and 34.2% of cases treated with csDMARDs during a median 21-month follow-up. Longitudinal changes in forced vital capacity and diffusing capacity for carbon monoxide were comparable between the two groups. However, the abatacept group showed a more significant decrease in DAS28-ESR and glucocorticoid doses than csDMARDs group during the follow-up. The safety of both regimens was comparable. Conclusions Abatacept and csDMARDs showed comparable effects on the development and stabilization of RA-ILD. Nevertheless, compared to csDMARDs, abatacept demonstrated a significant improvement in disease activity and led to reduced glucocorticoid use.

PURPOSE Developmental disabilities often result in decreased physical fitness and problematic behaviors. Participating in regular physical activity and exercise is one of the main ways to improve problems associated with developmental disabilities. In this study, we aimed to develop an evidence-based exercise program tailored to the characteristics, disability level, and functional level of children with developmental disabilities. METHODS The development process is composed of the following nine steps: preliminary literature review, survey of physical activity participation, first expert group discussion, development of the first exercise program, feasibility study, focus group interview, second expert group discussion, development of the evidence-based exercise program, the validation of the developed exercise program. RESULTS Participating in the evidence-based exercise program developed in this study was found to significantly improve cardiovascular fitness (6-minute walk), agility (standing long jump), and muscular function (sit-ups), but did not yield significant results in terms of flexibility (sit-and-reach). Additionally, the exercise program showed significant results in terms of reducing problem behaviors. The parents of children with developmental disabilities were all satisfied with the exercise program and its outcomes. CONCLUSIONS The evidence-based exercise program developed in this study had positive effects on the physical fitness and behavior of children with developmental disabilities. This study provides a basis for the development of exercise programs through a safe and effective means for children with developmental disabilities.