Nobunori Takahashi1, Toshihisa Kojima2, Atsushi Kaneko2, Daihei Kida2, Yuji Hirano2, Takayoshi Fujibayashi2, Yuichiro Yabe2, Hideki Takagi2, Takeshi Oguchi2, Hiroyuki Miyake2, Takefumi Kato2, Tsuyoshi Watanabe2, Masatoshi Hayashi2, Yasuhide Kanayama2, Koji Funahashi2, Shuji Asai2, Yutaka Yoshioka2, Toki Takemoto2, Kenya Terabe2, Nobuyuki Asai2, Naoki Ishiguro2. 1. From the Department of Orthopedic Surgery and Rheumatology, Nagoya University Graduate School of Medicine, and Nagoya Medical Centre, and Nagoya Central Hospital, Nagoya; Department of Rheumatology, Toyohashi Municipal Hospital, Toyohashi; Department of Orthopedic Surgery, Konan Kosei Hospital, Konan; Department of Rheumatology, Tokyo Kosei Nenkin Hospital, Tokyo; Department of Orthopedic Surgery, Anjo Kosei Hospital, Anjo; Department of Orthopedic Surgery, Ichinomiya Municipal Hospital, Ichinomiya; Kato Orthopedic Clinic, Okazaki; Department of Orthopedic Surgery, Kariya-Toyota General Hospital, Kariya; Department of Rheumatology, Nagano Red Cross Hospital, Nagano; Department of Orthopedic Surgery, Toyota Kosei Hospital, Toyota, Japan.N. Takahashi, MD, PhD; T. Kojima, MD, PhD; Department of Orthopedic Surgery and Rheumatology, Nagoya University Graduate School of Medicine; A. Kaneko, MD; D. Kida, MD, PhD; Department of Orthopedic Surgery and Rheumatology, Nagoya Medical Centre; Y. Hirano, MD, PhD, Department of Rheumatology, Toyohashi Municipal Hospital; T. Fujibayashi, MD, PhD, Department of Orthopedic Surgery, Konan Kosei Hospital; Y. Yabe, MD, PhD, Department of Rheumatology, Tokyo Kosei Nenkin Hospital; H. Takagi, MD, PhD, Department of Orthopedic Surgery, Nagoya Central Hospital; T. Oguchi, MD, PhD, Department of Orthopedic Surgery, Anjo Kosei Hospital; H. Miyake, MD, PhD, Department of Orthopedic Surgery, Ichinomiya Municipal Hospital; T. Kato, MD, PhD, Kato Orthopedic Clinic; T. Watanabe, MD, PhD, Department of Orthopedic Surgery, Kariya-Toyota General Hospital; M. Hayashi, MD, Department of Rheumatology, Nagano Red Cross Hospital; Y. Kanayama, MD, PhD, Department of Orthopedic Surgery, Toyota Kosei Hospital; K. Funahashi, MD, PhD; S. Asai, MD, PhD; Y. Yoshioka, MD, PhD; T. Takemoto, MD; K. Terabe, MD; N. Asai, MD; N. Ishiguro, MD, PhD, Department of Orthopedic Surgery and Rheumatology, Nagoya University Graduate School of Medicine. nobunori@med.nagoya-u.ac. 2. From the Department of Orthopedic Surgery and Rheumatology, Nagoya University Graduate School of Medicine, and Nagoya Medical Centre, and Nagoya Central Hospital, Nagoya; Department of Rheumatology, Toyohashi Municipal Hospital, Toyohashi; Department of Orthopedic Surgery, Konan Kosei Hospital, Konan; Department of Rheumatology, Tokyo Kosei Nenkin Hospital, Tokyo; Department of Orthopedic Surgery, Anjo Kosei Hospital, Anjo; Department of Orthopedic Surgery, Ichinomiya Municipal Hospital, Ichinomiya; Kato Orthopedic Clinic, Okazaki; Department of Orthopedic Surgery, Kariya-Toyota General Hospital, Kariya; Department of Rheumatology, Nagano Red Cross Hospital, Nagano; Department of Orthopedic Surgery, Toyota Kosei Hospital, Toyota, Japan.N. Takahashi, MD, PhD; T. Kojima, MD, PhD; Department of Orthopedic Surgery and Rheumatology, Nagoya University Graduate School of Medicine; A. Kaneko, MD; D. Kida, MD, PhD; Department of Orthopedic Surgery and Rheumatology, Nagoya Medical Centre; Y. Hirano, MD, PhD, Department of Rheumatology, Toyohashi Municipal Hospital; T. Fujibayashi, MD, PhD, Department of Orthopedic Surgery, Konan Kosei Hospital; Y. Yabe, MD, PhD, Department of Rheumatology, Tokyo Kosei Nenkin Hospital; H. Takagi, MD, PhD, Department of Orthopedic Surgery, Nagoya Central Hospital; T. Oguchi, MD, PhD, Department of Orthopedic Surgery, Anjo Kosei Hospital; H. Miyake, MD, PhD, Department of Orthopedic Surgery, Ichinomiya Municipal Hospital; T. Kato, MD, PhD, Kato Orthopedic Clinic; T. Watanabe, MD, PhD, Department of Orthopedic Surgery, Kariya-Toyota General Hospital; M. Hayashi, MD, Department of Rheumatology, Nagano Red Cross Hospital; Y. Kanayama, MD, PhD, Department of Orthopedic Surgery, Toyota Kosei Hospital; K. Funahashi, MD, PhD; S. Asai, MD, PhD; Y. Yoshioka, MD, PhD; T. Takemoto, MD; K. Terabe, MD; N. Asai, MD; N. Ishiguro, MD, PhD, Department of Orthopedic Surgery and Rheumatology, Nagoya University Graduate School of Medicine.
Abstract
OBJECTIVE: Our study aimed to evaluate the longterm efficacy and safety of abatacept (ABA), and to explore factors that increase its longterm efficacy in patients with rheumatoid arthritis (RA) treated in routine clinical practice. METHODS: There were 231 participants with RA treated with ABA who were prospectively registered in a Japanese multicenter registry. They were followed up for at least 52 weeks. RESULTS: Mean age of the patients was 64.3 years, mean disease duration was 12.1 years, mean 28-joint Disease Activity Score (DAS28)-C-reactive protein was 4.49, and 48.5% of patients were concomitantly treated with methotrexate (MTX). Overall retention rate of ABA was 77.1% at 52 weeks; 14.8% of patients discontinued because of inadequate response and 3.5% because of adverse events. The proportion of patients achieving DAS28-defined low disease activity (LDA) significantly increased from baseline to 52 weeks (7.3% to 43.8%, p < 0.01); 40.9% of patients who did not achieve LDA at 24 weeks had more than 1 categorical improvement in DAS28-defined disease activity at 52 weeks. Multivariate logistic regression revealed concomitant MTX use to be an independent predictor of the categorical improvement in DAS28-defined disease activity from 24 to 52 weeks (adjusted OR 3.124, p = 0.010). CONCLUSION: In routine clinical practice, ABA demonstrated satisfactory clinical efficacy and safety in patients with established RA for 52 weeks. The clinical efficacy of ABA increased with time even after 24 weeks, and this was strongly influenced by concomitant MTX use. Our study provides valuable real-world findings on the longterm management of RA with ABA.
OBJECTIVE: Our study aimed to evaluate the longterm efficacy and safety of abatacept (ABA), and to explore factors that increase its longterm efficacy in patients with rheumatoid arthritis (RA) treated in routine clinical practice. METHODS: There were 231 participants with RA treated with ABA who were prospectively registered in a Japanese multicenter registry. They were followed up for at least 52 weeks. RESULTS: Mean age of the patients was 64.3 years, mean disease duration was 12.1 years, mean 28-joint Disease Activity Score (DAS28)-C-reactive protein was 4.49, and 48.5% of patients were concomitantly treated with methotrexate (MTX). Overall retention rate of ABA was 77.1% at 52 weeks; 14.8% of patients discontinued because of inadequate response and 3.5% because of adverse events. The proportion of patients achieving DAS28-defined low disease activity (LDA) significantly increased from baseline to 52 weeks (7.3% to 43.8%, p < 0.01); 40.9% of patients who did not achieve LDA at 24 weeks had more than 1 categorical improvement in DAS28-defined disease activity at 52 weeks. Multivariate logistic regression revealed concomitant MTX use to be an independent predictor of the categorical improvement in DAS28-defined disease activity from 24 to 52 weeks (adjusted OR 3.124, p = 0.010). CONCLUSION: In routine clinical practice, ABA demonstrated satisfactory clinical efficacy and safety in patients with established RA for 52 weeks. The clinical efficacy of ABA increased with time even after 24 weeks, and this was strongly influenced by concomitant MTX use. Our study provides valuable real-world findings on the longterm management of RA with ABA.
Authors: Noelia Marquez Pete; María Del Mar Maldonado Montoro; Cristina Pérez Ramírez; Almudena Sánchez Martín; Juan Enrique Martínez de la Plata; Fernando Martínez Martínez; Rafael Caliz Caliz; Abdelali Daddaoua; María Del Carmen Ramírez Tortosa; Alberto Jiménez Morales Journal: J Pers Med Date: 2020-11-11