Efficacy and prognostic factors of treatment retention with intravenous abatacept for rheumatoid arthritis: 24-month results from an international, prospective, real-world study

被引：1

作者：

Nuesslein, H. G. ^{[1
]}

Alten, R. ^{[2
]}

Galeazzi, M. ^{[3
]}

Lorenz, H. -M. ^{[4
]}

Nurmohamed, M. T. ^{[5
]}

Bensen, W. G. ^{[6
,7
]}

Burmester, G. R. ^{[8
]}

Peter, H. -H. ^{[9
]}

Peichl, P. ^{[10
]}

Pavelka, K. ^{[11
]}

Chartier, M. ^{[12
]}

Poncet, C. ^{[13
]}

Rauch, C. ^{[14
]}

Le Bars, M. ^{[15
]}

机构：

[1] Univ Erlangen Nurnberg, Rheumatol Schwerpunktpraxis, Kontumazgarten 4, D-90429 Nurnberg, Germany

[2] Schlosspk Klin Univ Med, Berlin, Germany

[3] Univ Siena, Via Laterina 8, I-53100 Siena, Italy

[4] Univ Heidelberg Hosp, Heidelberg, Germany

[5] Vrije Univ Amsterdam, Med Ctr, Jan van Breeman Res Inst, Amsterdam, Netherlands

[6] St Josephs Hosp, Hamilton, ON, Canada

[7] McMaster Univ, Hamilton, ON, Canada

[8] Charite, D-13353 Berlin, Germany

[9] Univ Freiburg, Hugstetter Str 55, D-79106 Freiburg, Germany

[10] Evangel Krankenhaus, Vienna, Austria

[11] Inst Rheumatol, Prague, Czech Republic

[12] Chiltern Int, Neuilly, France

[13] DOCS Int, Nanterre, France

[14] Bristol Myers Squibb Co, Munich, Germany

[15] Bristol Myers Squibb Co, Rueil Malmaison, France

来源：

CLINICAL AND EXPERIMENTAL RHEUMATOLOGY | 2016年 / 34卷 / 03期

关键词：

abatacept; biological therapy; cohort studies; cyclic citrullinated peptide; rheumatoid arthritis; rheumatoid factor; ANTITUMOR NECROSIS FACTOR; CYCLIC CITRULLINATED PEPTIDE; DRUG RETENTION; AGENTS; POSITIVITY; REMISSION; TOCILIZUMAB; ADALIMUMAB; RITUXIMAB; SURVIVAL;

D O I：

暂无

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objective To evaluate retention of abatacept over 24 months in patients with rheumatoid arthritis (RA) in routine clinical practice across Europe and Canada. Methods ACTION (AbataCepT In rOutiNe clinical practice) was a prospective, observational, multicentre study of adult patients with moderate-to-severe RA who, at their physician's discretion, initiated treatment with intravenous abatacept. Enrolment occurred from May 2008 to December 2010, with up to 30 months of follow-up. The primary endpoint was the abatacept retention rate over 24 months. Crude abatacept retention rate was estimated using the Kaplan-Meier method. Prognostic factors of abatacept retention in patients with >= 1 prior biologic failure were derived from a Cox proportional hazards regression model, accounting for clustered data. Results A total of 1137 patients were enrolled (1573 patient-years on abatacept); most (89.2%) had experienced prior biologic failure. The overall crude abatacept retention rate at 24 months was 54.4% (95% confidence interval: 51.3, 57.4). Positivity for both rheumatoid factor and anti-cyclic citrullinated antibody, previous exposure to one or no anti-tumour necrosis factor agents, and cardiovascular comorbidity were prognostic of higher abatacept retention. Erythrocyte sedimentation rate >= 51 mm/hour and introduction of corticosteroid use at abatacept initiation were predictors of lower abatacept retention. Abatacept retention varied according to country. Abatacept was well tolerated without any unexpected safety signals. Conclusion In a real-world setting, intravenous abatacept treatment retention was more than 50% at 24 months. The identification of prognostic factors of abatacept retention could support individualised biologic treatment strategies in patients with moderate-to-severe RA.

引用

页码：489 / 499

页数：11