Background/Purpose: Currently, the most widely used biological agents for rheumatoid arthritis (RA) patients are the inhibitors of the tumor necrosis factor (TNFi), although other biological agents with different mechanisms of actions, such abatacept, have been approved in the recent years. Although all these drugs are indicated in RA, there is limited data on their use in clinical practice. Our objective is to analyze if there are differences in baseline characteristics of RA patients treated with abatacept, a T-cell costimulation inhibitor, compared with those treated with a TNFi

Methods:  All BIOBADASER 2.0 register patients diagnosed with RA and treated with abatacept from January 2008 to December 2014 were selected. Baseline sociodemographic and clinical characteristics were analyzed compared them with RA patients treated with TNFi during the same period. Variables analyzed: age; gender; disease duration; positivity of rheumatoid factor (RF); disease activity at index time (time when the biological drug was initiated) measured by the DAS28-ESR score; number of previous biological agents (0, 1, ≥ 2); and concomitant glucocorticoid treatment. Differences between groups (abatacept vs TNFi) in the baseline DAS28-ESR were analized according to the number of previous biological drugs received 

Results: From January 2008 to December 2014, 252 RA patients treated with abatacept and 640 with TNFi were included in the BIOBADASER 2.0 register. Baseline characteristics are shown in Table 1. At baseline, patients treated with abatacept were significantly younger [52.2 (± 13.1) vs 54.6 (± 13.7) years, p=0.018]; had a longer disease duration [12.1 (± 8.1) vs 7.3 (± 8.0) years; p<0.001] and had received a higher number of previous biologics (28.2% vs 7.8% had received one previous biologic; p<0.001; 61.1% vs 1.88% had received ≥ 2 previous biologics; p<0.001). When baseline DAS28-ESR was analyzed, both clustered and stratified according to the number of previous biologics, higher DAS28-ESR was found in RA patients treated with abatacept compared with those treated with anti-TNF, that was statistically significant in patients who had received one previous biologic [DAS28-ESR: 5.20 (± 1.53) vs 4.09 (± 1.95); p<0.001]. No differences were found in gender, positivity of RF and concomitant treatment with glucocorticoids between groups. Table 1. Baseline Characteristics of Abatacept and TNF inhibitors patients in BIOBADASER 2.0 Registry

*p<0.05 **Index date: Age at the time of start of the first biologic ***Number of treatments started in every group available to calculate the DAS28 mean.

Conclusion: Patients with RA treated with abatacept have higher baseline inflammatory activity, a significantly longer disease duration, and have failed more previous biological agents than those treated with TNF inhibitors

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/analysis-of-baseline-characteristics-of-rheumatoid-arthritis-patients-treated-with-abatacept-compared-to-those-treated-with-tumor-necrosis-factor-inhibitors-in-clinical-practice/