Predictors of abatacept retention over 2 years in patients with rheumatoid arthritis: results from the real-world ACTION study

Journal article


Publication Details

Author(s): Alten R, Mariette X, Lorenz HM, Nüsslein H, Galeazzi M, Navarro F, Chartier M, Heitzmann J, Poncet C, Rauch C, Le Bars M
Journal: Clinical Rheumatology
Publication year: 2019
Volume: 38
Journal issue: 5
Pages range: 1413-1424
ISSN: 0770-3198


Abstract

Objectives: Evaluate abatacept retention over 2 years in the AbataCepT In rOutiNe clinical practice (ACTION) study. Method: ACTION was an international, observational study of patients with moderate-to-severe rheumatoid arthritis (RA) who initiated intravenous abatacept. Crude abatacept retention rates over 2 years were estimated using Kaplan–Meier analyses in biologic-naive and -failure patients. Clinically relevant risk factors and significant prognostic factors for retention were evaluated using a Cox proportional hazards multivariable model. Results: Overall, 2350/2364 enrolled patients were evaluable; 673 (28.6%) were biologic naive and 1677 (71.4%) had prior biologic failure (1 biologic, 728/1677 [43.4%]; ≥ 2 biologics, 949/1677 [56.6%]). Abatacept retention rate (95% confidence interval [CI]) at 2 years was 47.9% (45.7, 50.0): 54.5% (50.4, 58.3) for biologic-naive vs 45.2% (42.7, 47.7) for biologic-failure patients (log-rank P < 0.001). For patients with 1 and ≥ 2 prior biologic failures, respectively, retention rates (95% CI) were 50.2% (46.3, 53.9) vs 41.3% (38.0, 44.6; log-rank P < 0.001). Main reasons for discontinuation (biologic-naive vs biologic-failure, respectively) were lack of efficacy (61.4 vs 67.7%) and safety (21.3 vs 21.2%). Rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) double positivity versus negativity were predictive of higher retention in both biologic-naive (hazard ratio [HR] [95% CI] 0.71 [0.53, 0.96]; P = 0.019) and biologic-failure patients (HR [95% CI] 0.76 [0.62, 0.94]; P = 0.035). Conclusions: Abatacept initiation as earlier vs later line of therapy in RA may achieve higher 2-year retention rates. RF and anti-CCP seropositivity could predict increased abatacept retention, irrespective of treatment line. Trial registration: NCT02109666.


FAU Authors / FAU Editors

Nüsslein, Hubert PD Dr.
Medizinische Fakultät


Additional Organisation
Medizinische Klinik 3 - Rheumatologie und Immunologie


External institutions with authors

Bristol-Myers Squibb
Charité - Universitätsmedizin Berlin
Excelya Paris
Hospitales Universitarios Virgen Macarena y Virgen del Rocío
Università degli Studi di Siena (UNISI) / University of Siena
Universitätsklinikum Heidelberg
University of Paris 11 - Paris-Sud / Université Paris XI Paris-Sud


How to cite

APA:
Alten, R., Mariette, X., Lorenz, H.M., Nüsslein, H., Galeazzi, M., Navarro, F.,... Le Bars, M. (2019). Predictors of abatacept retention over 2 years in patients with rheumatoid arthritis: results from the real-world ACTION study. Clinical Rheumatology, 38(5), 1413-1424. https://dx.doi.org/10.1007/s10067-019-04449-w

MLA:
Alten, Rieke, et al. "Predictors of abatacept retention over 2 years in patients with rheumatoid arthritis: results from the real-world ACTION study." Clinical Rheumatology 38.5 (2019): 1413-1424.

BibTeX: 

Last updated on 2019-03-06 at 11:23