Kosaku Murakami1, Masahiro Sekiguchi2,3, Shintaro Hirata4, Takao Fujii5, Kiyoshi Matsui2, Satoshi Morita6, Koichiro Ohmura1, Yutaka Kawahito7, Norihiro Nishimoto8,9, Tsuneyo Mimori1, Hajime Sano2. 1. a Department of Rheumatology and Clinical Immunology, Graduate School of Medicine , Kyoto University , Kyoto , Japan. 2. b Department of Internal Medicine, Division of Rheumatology, Hyogo College of Medicine , Nishinomiya , Japan. 3. c Department of Internal Medicine, Division of Rheumatology , Hyogo Prefectural Nishinomiya Hospital , Nishinomiya , Japan. 4. d Department of Clinical Immunology and Rheumatology , Hiroshima University Hospital , Hiroshima, Japan. 5. e Department of Clinical Immunology and Rheumatology , Wakayama Medical University , Wakayama , Japan. 6. f Biomedical Statistics and Bioinformatics , Kyoto University , Kyoto , Japan. 7. g Inflammation and Immunology, Graduate School of Medical Science , Kyoto Prefectural University of Medicine , Kyoto , Japan. 8. h Osaka Rheumatology Clinic , Osaka , Japan. 9. i Department of Molecular Regulation for Intractable Diseases , Institute of Medical Science, Tokyo Medical University , Tokyo , Japan.
Abstract
OBJECTIVE: To investigate the effect of abatacept (ABA) on preventing joint destruction in biological disease-modifying anti-rheumatic drug (bDMARD)-naïve rheumatoid arthritis (RA) patients in real-world clinical practice. PATIENTS AND METHODS: RA patients were collected from the ABROAD (ABatacept Research Outcomes as a First-line Biological Agent in the Real WorlD) study cohort. They had moderate or high disease activity and were treated with ABA as a first-line bDMARD. Radiographic change between baseline and 1 year after ABA treatment was assessed with the van der Heijde's modified Total Sharp Score (mTSS). Predictive factors for structural remission (St-REM), defined as ΔmTSS ≤0.5/year, were determined. RESULTS: Among 118 patients, 81 (67.5%) achieved St-REM. Disease duration <3 years (odds ratio (OR) = 3.152, p = .007) and slower radiographic progression (shown as 'baseline mTSS/year <3', OR = 3.727, p = .004) were independently significant baseline predictive factors for St-REM irrespective of age and sex. St-REM prevalence increased significantly if clinical remission based on the Simplified Disease Activity Index was achieved at least once until 24 weeks after ABA treatment. CONCLUSION: Shorter disease duration, smaller radiographic progression at baseline, and rapid clinical response were predictive factors for sustained St-REM after ABA therapy in bDMARD-naïve RA patients.
OBJECTIVE: To investigate the effect of abatacept (ABA) on preventing joint destruction in biological disease-modifying anti-rheumatic drug (bDMARD)-naïve rheumatoid arthritis (RA) patients in real-world clinical practice. PATIENTS AND METHODS: RApatients were collected from the ABROAD (ABatacept Research Outcomes as a First-line Biological Agent in the Real WorlD) study cohort. They had moderate or high disease activity and were treated with ABA as a first-line bDMARD. Radiographic change between baseline and 1 year after ABA treatment was assessed with the van der Heijde's modified Total Sharp Score (mTSS). Predictive factors for structural remission (St-REM), defined as ΔmTSS ≤0.5/year, were determined. RESULTS: Among 118 patients, 81 (67.5%) achieved St-REM. Disease duration <3 years (odds ratio (OR) = 3.152, p = .007) and slower radiographic progression (shown as 'baseline mTSS/year <3', OR = 3.727, p = .004) were independently significant baseline predictive factors for St-REM irrespective of age and sex. St-REM prevalence increased significantly if clinical remission based on the Simplified Disease Activity Index was achieved at least once until 24 weeks after ABA treatment. CONCLUSION: Shorter disease duration, smaller radiographic progression at baseline, and rapid clinical response were predictive factors for sustained St-REM after ABA therapy in bDMARD-naïve RApatients.
Entities:
Keywords:
Abatacept; first biological DMARDs; radiographic progression; rheumatoid arthritis