https://doi.org/10.4081/reumatismo.2024.1608
Retention rate of abatacept in rheumatoid arthritis patients in a real-life setting: results from a monocentric cohort
Submitted: 6 July 2023
Accepted: 22 February 2024
Published: 24 June 2024
Accepted: 22 February 2024
Abstract Views: 148
PDF: 89
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Objective. Data from trials demonstrated that abatacept (ABA) has a good safety and efficacy profile in treating rheumatoid arthritis. We have studied the retention rate of ABA in a real-life cohort of patients with rheumatoid arthritis.
Methods. This is a monocentric, retrospective study including patients with rheumatoid arthritis classified by the American College of Rheumatology/European League Against Rheumatism 2010 criteria who started treatment with ABA. The Kaplan-Meier method was applied to evaluate the ABA retention rate.
Results. This analysis was conducted on 161 patients [male/female 21/140, median age 65 years, interquartile range (IQR) 18.7, median disease duration 169 months, IQR 144.0]. 111 patients (68.9%) received ABA subcutaneously. ABA was associated with methotrexate in 61.9% of patients and was the first biological disease-modifying antirheumatic drug in 41%. We observed a median ABA survival of 66 months [95% confidence interval (CI) 57.3-74.7], with a retention rate of 88% at 6 months and 50.9% at 5 years. Drug survival was significantly higher in patients treated with ABA subcutaneously and in male patients (p=0.039 and p=0.018, respectively). Adjusted for main confounders, female gender was the main predictor of withdrawal (hazard ratio 5.1, 95% CI 1.2-21.3).
Conclusions. Our study shows that better survival is associated with subcutaneous administration and male gender, confirming ABA effectiveness.
Aletaha D, Smolen JS. Diagnosis and management of rheumatoid arthritis: a review. JAMA 2018; 320: 1360-72.
DOI: https://doi.org/10.1001/jama.2018.13103
Chatzidionysiou K, Emamikia S, Nam J, Ramiro S, Smolen J, van der Heijde D, Dougados M, et al. Efficacy of glucocorticoids, conventional and targeted synthetic disease-modifying antirheumatic drugs: a systematic literature review informing the 2016 update of the EULAR recommendations for the management of rheumatoid arthritis. Ann Rheum Dis 2017; 76: 1102-7.
DOI: https://doi.org/10.1136/annrheumdis-2016-210711
Smolen JS, Landewé RBM, Bergstra SA, Kerschbaumer A, Sepriano A, Aletaha D, et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2022 update. Ann Rheum Dis 2023; 82: 3-18. Erratum in: Ann Rheum Dis 2023; 82: e76.
DOI: https://doi.org/10.1136/ard-2022-223356corr1
Conti F, Ceccarelli F, Massaro L, Cipriano E, Di Franco M, Alessandri C, et al. Biological therapies in rheumatic diseases. Clin Ter 2013; 164: e413-28.
Moreland L, Bate G, Kirkpatrick P. Abatacept. Nat Rev Drug Discov 2006; 5: 185-6.
DOI: https://doi.org/10.1038/nrd1989
Blair HA, Deeks ED. Abatacept: a review in rheumatoid arthritis. Drugs 2017; 77: 1221-33.
DOI: https://doi.org/10.1007/s40265-017-0775-4
Alten R, Kaine J, Keystone E, Nash P, Delaet I, Genovese MC. Long-term safety of subcutaneous abatacept in rheumatoid arthritis: integrated analysis of clinical trial data representing more than four years of treatment. Arthritis Rheumatol 2014; 66: 1987-97.
DOI: https://doi.org/10.1002/art.38687
Weinblatt ME, Moreland LW, Westhovens R, Cohen RB, Kelly SM, Khan N, et al. Safety of abatacept administered intravenously in treatment of rheumatoid arthritis: integrated analyses of up to 8 years of treatment from the abatacept clinical trial program. J Rheumatol 2013; 40: 787-97.
DOI: https://doi.org/10.3899/jrheum.120906
Blonde L, Khunti K, Harris SB, Meizinger C, Skolnik NS. Interpretation and impact of real-world clinical data for the practicing clinician. Adv Ther 2018; 35: 1763-74.
DOI: https://doi.org/10.1007/s12325-018-0805-y
Kay J, Upchurch KS. ACR/EULAR 2010 rheumatoid arthritis classification criteria. Rheumatology (Oxford) 2012; 51 Suppl 6: vi5-9.
DOI: https://doi.org/10.1093/rheumatology/kes279
van Riel PL, Renskers L. The disease activity score (DAS) and the disease activity score using 28 joint counts (DAS28) in the management of rheumatoid arthritis. Clin Exp Rheumatol 2016; 34: S40-4.
Cagnotto G, Willim M, Nilsson JÅ, Compagno M, Jacobsson LTH, Saevarsdottir S, et al. Abatacept in rheumatoid arthritis: survival on drug, clinical outcomes, and their predictors-data from a large national quality register. Arthritis Res Ther 2020; 22: 15.
DOI: https://doi.org/10.1186/s13075-020-2100-y
Westhovens R, Connolly SE, Margaux J, Vanden Berghe M, Maertens M, Van den Berghe M, et al. Up to 5-year retention of abatacept in Belgian patients with moderate-to-severe rheumatoid arthritis: a sub-analysis of the international, observational ACTION study. Rheumatol Int 2020; 40: 1409-21.
DOI: https://doi.org/10.1007/s00296-020-04619-z
Salmon JH, Letarouilly JG, Goëb V, Kanagaratnam L, Coquerelle P, Guyot MH, et al. Actual persistence of abatacept in rheumatoid arthritis: results of the French-Ric network. J Clin Med 2020; 9: 1528.
DOI: https://doi.org/10.3390/jcm9051528
Ogawa N, Ohashi H, Ota Y, Kobori K, Suzuki M, Tsuboi S, et al. Multicenter, observational clinical study of abatacept in Japanese patients with rheumatoid arthritis. Immunol Med 2019; 42: 29-38. Erratum in: Immunol Med 2019; 42: 50-2.
DOI: https://doi.org/10.1080/25785826.2019.1605036
Pope JE, Rampakakis E, Sampalis J. The durability of abatacept as a first and subsequent biologic and improvement in HAQ from a large multi-site real-world study. Semin Arthritis Rheum 2015; 44: 499-505.
DOI: https://doi.org/10.1016/j.semarthrit.2014.09.009
Nüßlein HG, Alten R, Galeazzi M, Lorenz HM, Boumpas D, Nurmohamed MT, et al. Real-world effectiveness of abatacept for rheumatoid arthritis treatment in European and Canadian populations: a 6-month interim analysis of the 2-year, observational, prospective ACTION study. BMC Musculoskelet Disord 2014; 15: 14.
DOI: https://doi.org/10.1186/1471-2474-15-14
Mariette X, Schaeverbeke T, Gaudin P, Chartier M, Heitzmann J, Vannier-Moreau V, et al. Two-year abatacept retention rate in clinical practice in the French ACTION cohort. Joint Bone Spine 2019; 86: 753-9.
DOI: https://doi.org/10.1016/j.jbspin.2019.07.006
Nüßlein HG, Alten R, Galeazzi M, Lorenz HM, Nurmohamed MT, Bensen WG, et al. Prognostic factors for abatacept retention in patients who received at least one prior biologic agent: an interim analysis from the observational, prospective ACTION study. BMC Musculoskelet Disord 2015; 16: 176.
DOI: https://doi.org/10.1186/s12891-015-0636-9
Okazaki S, Watanabe R, Harigae H, Fujii H. Better retention of abatacept is associated with high rheumatoid factor: a five-year follow-up study of patients with rheumatoid arthritis. Tohoku J Exp Med 2020; 250: 153-9.
DOI: https://doi.org/10.1620/tjem.250.153
Alten R, Mariette X, Lorenz HM, Nüßlein H, Galeazzi M, Navarro F, et al. Predictors of abatacept retention over 2 years in patients with rheumatoid arthritis: results from the real-world ACTION study. Clin Rheumatol 2019; 38: 1413-24. Erratum in: Clin Rheumatol 2019; 38: 1535.
DOI: https://doi.org/10.1007/s10067-019-04449-w
Genovese MC, Covarrubias A, Leon G, Mysler E, Keiserman M, Valente R, et al. Subcutaneous abatacept versus intravenous abatacept: a phase IIIb noninferiority study in patients with an inadequate response to methotrexate. Arthritis Rheum 2011; 63: 2854-64.
DOI: https://doi.org/10.1002/art.30463
Iwahashi M, Inoue H, Matsubara T, Tanaka T, Amano K, Kanamono T, et al. Efficacy, safety, pharmacokinetics and immunogenicity of abatacept administered subcutaneously or intravenously in Japanese patients with rheumatoid arthritis and inadequate response to methotrexate: a Phase II/III, randomized study. Mod Rheumatol 2014; 24: 885-91.
DOI: https://doi.org/10.3109/14397595.2014.881954
How to Cite
Molteni, E., Pirone, C., Ceccarelli, F., Castellani, C., Alessandri, C., Di Franco, M., Riccieri, V., Spinelli, F., Priori, R., Scrivo, R., & Conti, F. (2024). Retention rate of abatacept in rheumatoid arthritis patients in a real-life setting: results from a monocentric cohort. Reumatismo, 76(2). https://doi.org/10.4081/reumatismo.2024.1608
Copyright (c) 2024 the Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.