Similar Short Term Survival on Drug for Patients with Rheumatoid Arthritis Treated with Subcutaneous and Intravenous Abatacept – Results from the National Swedish Rheumatology Quality Register

Carl Turesson¹, Leszek Stawiarz², Staffan Lindblad³ and Saedis Saevarsdottir⁴, ¹Section of Rheumatology, Department of Clinical Sciences, Malmö, Lund University, Malmö, Sweden, ²Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden, ³Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden, ⁴Rheumatology Unit, Department of Medicine, Karolinska institutet and Karolinska University Hospital, Stockholm, Sweden

Meeting: 2014 ACR/ARHP Annual Meeting

Keywords: Abatacept, registry and rheumatoid arthritis (RA)

Session Information

Title: Rheumatoid Arthritis - Small Molecules, Biologics and Gene Therapy: Safety of Biologics and Small Molecules in Rheumatoid Arthritis

Session Type: Abstract Submissions (ACR)

Background/Purpose

Abatacept is a biological anti-rheumatic drug used in Rheumatoid Arthritis (RA). Data on patient characteristics, diagnosis, previous treatment and outcomes of abatacept have been collected in the Swedish Rheumatology Quality register (SRQ) which comprises the Swedish Biologics (ARTIS; Arthritis Treatment In Sweden) register, since the drug was approved in 2006. In early 2013, subcutaneous treatment with abatacept became available. The objective of this study was to investigate baseline characterstics and drug survival probability in clinical practice for patients with RA treated with subcutaneous (sc) vs. intravenous (iv) abatacept, using a national register.

Methods Observational data from the SRQ for the period when both iv and sc abatacept were available, January, 2013 to May 20, 2014, were obtained. Kaplan-Meier survival analysis with right censoring and log-rank test of equality across strata were performed and Šidák multiple-comparison adjustments applied.

Results A total of 371 patients with RA were started on their first treatment with abatacept during the study period (252 with sc administration and 119 with iv treatment). Age (mean 58.7 vs 59.7 years), RA duration at treatment initiation (median 12.8 vs 13.2 years) and sex distribution (79 % vs 81 % women) were similar in the two groups, and there was no major difference in baseline disease activity (DAS28; mean 5.10 vs. 4.98). Among those receiving sc treatment, 21 % were bio-naïve, 26 % had previously been exposed to one biologic drug, and 53 % to ≥ 2 biologics. The corresponding figures among those treated with iv abatacept were 17%/ 30%/ 53 %. There was no significant difference in the survival on drug for those on sc, compared to iv treatment (p=0.19). The estimated survival rates at 6 months were 76 % (sc) and 81 % (iv). Furthermore, there were no significant differences in drug survival in analyses stratified by previous exposure to biologics (p=0.73 for bio-naïve patients, p=0.19 for those with 1 previous biologic, and p=0.32 for those with ≥ 2 previous biologics).

Conclusion In this observational study of a real-life national cohort, the majority of patients with RA started on abatacept since the subcutaneous administration form became available received that form of treatment. There were no major differences in baseline characteristics or short term survival on drug between patients treated with subcutaneous or intravenous abatacept. This supports clinical trials that have demonstrated similar efficacy and safety for the two routes of administration of abatacept.

Disclosure:

C. Turesson,

Unrestricted research grants from Abbvie, Pfizer and Roche,

Abvisory Boards: Bristol-Myers Squibb, MSD, Pfizer, Roche,

L. Stawiarz,
None;

S. Lindblad,
None;

S. Saevarsdottir,
None.

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