Date: Monday, November 6, 2017
Session Type: ACR Poster Session B
Session Time: 9:00AM-11:00AM
Background/Purpose: ACTION (NCT02109666) was the first prospective international non-interventional study designed to provide long-term real-world data on abatacept retention in patients (pts) with RA. The 1-y interim analyses of ACTION were reported previously.1
Methods: ACTION is a 2-y observational study of pts with moderate-to-severe RA who initiated IV abatacept as first- or second/further-line biologic therapy in routine clinical practice in Europe and Canada (May 2008–Dec 2013). Here we report the primary outcome of the study, ie 2-y crude abatacept retention rate with 95% CI (overall and by treatment line), estimated by Kaplan–Meier analysis. Additional study outcomes were crude retention rates by participating country, prognostic factors of retention, identifed by backward selection method in multivariate models, and EULAR response by treatment line and RF/anti-citrullinated protein antibody (ACPA) seropositivity, compared by Fisher’s exact test.
Results: In total, 2350/2364 enrolled pts were evaluable for analysis: 673 (28.6%) biologic naïve and 1677 (71.4%) biologic failures. Some expected differences in baseline characteristics were seen between groups and were reported previously.2 The 2-y retention rate was 47.9% (95% CI 45.7, 50.0) in the overall population, and was higher in biologic-naïve (54.5% [50.4, 58.3]) vs -failure pts (45.2% [42.7, 47.7]; p<0.001); main reasons for abatacept discontinuation were lack of efficacy (61.4 vs 67.7%) and safety (21.3 vs 21.2%).2 By country, overall retention rates were 37.5–66.7%; rates were highest in Belgium (66.7%) and Austria (60.5%). Retention rates were higher in biologic-naïve vs ‑failure pts (Figure). Predictors of higher abatacept retention2 included: RF/ ACPA seropositivity (p=0.030 biologic naïve; p=0.028 biologic failure); diabetes (p=0.044 biologic naïve); geographic location, Canada, Spain and Italy vs Germany (p<0.001 biologic naïve); and abatacept combination therapy (p<0.001 biologic failure). Only high Patient Global Assessment, ie ≥70, (p=0.009 biologic failure) predicted lower retention. At 2 y, a greater proportion of biologic-naïve vs -failure pts had good/moderate EULAR response (p=0.005); RF and/or ACPA seropositivity was associated with a significantly better response (p=0.007)].2
To cite this abstract in AMA style:Alten R, Lorenz H, Mariette X, Nüßlein H, Galeazzi M, Navarro F, Chartier M, Elbez Y, Rauch C, Le Bars M. Abatacept Retention Rates, Overall and By Participating Country, and Prognostic Factors of Retention in Patients with RA: 2-Year Results from a Real-World Observational Study [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/abatacept-retention-rates-overall-and-by-participating-country-and-prognostic-factors-of-retention-in-patients-with-ra-2-year-results-from-a-real-world-observational-study/. Accessed September 28, 2021.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/abatacept-retention-rates-overall-and-by-participating-country-and-prognostic-factors-of-retention-in-patients-with-ra-2-year-results-from-a-real-world-observational-study/