Abatacept in rheumatoid arthritis: survival on drug, clinical outcomes, and their predictors-data from a large national quality register

• Published in: Arthritis research & therapy 2020-01, Vol.22 (1), p.15-11, Article 15
• Main Authors: Cagnotto, Giovanni, Willim, Minna, Nilsson, Jan-Åke, Compagno, Michele, Jacobsson, Lennart T H, Saevarsdottir, Saedis, Turesson, Carl
• Format: Article
• Language: English
• Subjects: Abatacept; Antiarthritic agents; Antirheumatic agents; Arthritis; Clinical Medicine; Clinical outcomes; Clinical trials; Disease; disease-activity; Diseases; double-blind; Drug therapy; efficacy; etanercept; Health; inadequate response; infliximab; Klinisk medicin; major predictor; Male identity; Medical and Health Sciences; Medicin och hälsovetenskap; Methotrexate; Necrosis; Patients; remission; Response predictors; Reumatologi och inflammation; Rheumatoid arthritis; Rheumatoid factor; Rheumatology; Rheumatology and Autoimmunity; Survival on drug; Testing; therapy; TNF inhibitors; Treatment outcome; Tumor necrosis factor; Tumor necrosis factor-TNF; Tumors; Variables
• ISSN: 1478-6362; 1478-6354; 1478-6362
• DOI: 10.1186/s13075-020-2100-y

There are limited data regarding efficacy of abatacept treatment for rheumatoid arthritis (RA) outside clinical trials. Quality registers have been useful for observational studies on tumor necrosis factor inhibition in clinical practice. The aim of this study was to investigate clinical efficacy and tolerability of abatacept in RA, using a national register. RA patients that started abatacept between 2006 and 2017 and were included in the Swedish Rheumatology Quality register (N = 2716) were investigated. Survival on drug was estimated using Kaplan-Meier analysis. The European League Against Rheumatism (EULAR) good response and Health Assessment Questionnaire (HAQ) response (improvement of ≥ 0.3) rates (LUNDEX corrected for drug survival) at 6 and at 12 months were assessed. Predictors of discontinuation were investigated by Cox regression analyses, and predictors of clinical response by logistic regression. Significance-based backward stepwise selection of variables was used for the final multivariate models. There was a significant difference in drug survival by previous biologic disease-modifying antirheumatic drug (bDMARD) exposure (p