Are There Differences in Baseline Comorbidities Between Rheumatoid Arthritis Patients Treated with Abatacept and Those Treated with Tumor Necrosis Factor Inhibitors?

M. Victoria Hernández¹, Carlos Sánchez-Piedra², Jose Inciarte-Mundo¹, Fernando Sanchez-Alonso², Javier Manero³, Rosa Roselló⁴, Eva Pérez-Pampin⁵, Carlos Rodriguez-Lozano⁶, Cesar Diaz-Torné⁷, Raimon Sanmarti¹, Juan J. Gómez-Reino⁵ and Biobadaser 2.0 Study Group, ¹Rheumatology Department, Hospital Clínic de Barcelona, Barcelona, Spain, ²Research Unit, Spanish Society of Rheumatology, Madrid, Spain, ³Rheumatology, Hospital Miguel Servet, Zaragoza, Spain, ⁴Rheumatology, H San Jorge, Huesca, Spain, ⁵Rheumatology, Hospital Clínico Universitario. Santiago de Compostela, Santiago de Compostela, Spain, ⁶Rheumatology, Hospital de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain, ⁷Rheumatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain

Meeting: 2016 ACR/ARHP Annual Meeting

Date of first publication: September 28, 2016

Keywords: Abatacept, Co-morbidities, patient, rheumatoid arthritis (RA) and tumor necrosis factor (TNF)

Session Information

Date: Tuesday, November 15, 2016

Title: Rheumatoid Arthritis – Clinical Aspects - Poster III: Treatment – Monitoring, Outcomes, Adverse Events

Session Type: ACR Poster Session C

Session Time: 9:00AM-11:00AM

Background/Purpose: Rheumatoid arthritis (RA) patients frequently report concomitant comorbidities that could worsen their prognosis. Tumor necrosis factor inhibitors (TNFi), the most common biological agents used, have shown efficacy in RA patients, although use in RA patients with certain comorbidities warrant caution (1). Abatacept, a biologic agent with a different mechanism of action, inhibiting the co-stimulation of the T-lymphocyte, has demonstrated differentiated safety profile (2), that could influence the biological agent prescribed in RA patients with some associated comorbidities. Our objective is to analyze differences in the frequency of baseline comorbidities in RA patients treated with abatacept compared with those treated with TNFi

Methods: Patients with RA recruited into the BIOBADASER 2.0 register from January 2008 to December 2014 and treated with abatacept or TNFi with comorbidities were selected. Comorbidity was defined as ≥ 1 of the following at initiation of biological therapy: Ischemic heart disease; lymphoma; malignancy (except lymphoma); diabetes; chronic pulmonary obstructive disease (CPOD); smoking; hypercholesterolemia; hypertension; heart failure; renal failure; osteoporosis; Epstein Barr, hepatitis B or C virus infection; and others. We analyzed the frequency of each comorbiditiy and the differences in the rate of baseline comorbidities between the two groups

Results: From January 2008 to December 2014, 640 and 252 RA patients treated respectively with TNFi or abatacept, were included in the BIOBADASER 2.0 register, of whom 51.6% had ≥ 1 comorbitity at baseline. Frequencies for every basal comorbidity described ere shown in Table 1. There was a significantly higher rate of heart failure in abatacept than in TNFi patients. Other comorbidities showed no significant differences Table 1

	Frequency (%)
Comorbidities	Abatacept	TNFi	p-value
Ischemic heart disease	1(2.3)	14(2.1)	0.940
Malignancy (except lymphoma)	1(2.3)	13(1.9)	0.883
Diabetes	6(13.6)	46(6.9)	0.098
CPOD	2(4.6)	16(2.4)	0.382
Smoking	8(18.2)	109(16.4)	0.757
Hypercholesterolemia	9(20.4)	111(16.7)	0.519
Hypertension	10(22.7)	148(22.3)	0.942
Epstein Barr infection	0(0)	1(0.1)	0.797
Heart failure	4(9.1)	6(0.9)	<0.001
Renal failure	0(0)	8(1.2)	0.464
Lymphoma	0(0)	0(0)
Osteoporosis	7(15.9)	89(13.4)	0.635
Hepatitis B virus infection	1(2.3)	13(1.9)	0.883
Hepatitis C virus infection	0(0)	1(0.1)	0.797
Others	22(50)	292(43.9)	0.431

Conclusion: RA patients treated with abatacept had a higher baseline frequency of concomitant heart failure compared with patients treated with TNFi, probably reflecting different recommendations on biological drug use. No differences in other baseline comorbidities were found between groups References: (1) Singh et al. Arthritis Rheum 2016; 68: 1–26. (2) Singh et al. Cochrane Database Syst Rev. 2011; 16: CD008794

Disclosure: M. V. Hernández, None; C. Sánchez-Piedra, None; J. Inciarte-Mundo, None; F. Sanchez-Alonso, None; J. Manero, None; R. Roselló, None; E. Pérez-Pampin, None; C. Rodriguez-Lozano, None; C. Diaz-Torné, None; R. Sanmarti, None; J. J. Gómez-Reino, None.

To cite this abstract in AMA style:

Hernández MV, Sánchez-Piedra C, Inciarte-Mundo J, Sanchez-Alonso F, Manero J, Roselló R, Pérez-Pampin E, Rodriguez-Lozano C, Diaz-Torné C, Sanmarti R, Gómez-Reino JJ. Are There Differences in Baseline Comorbidities Between Rheumatoid Arthritis Patients Treated with Abatacept and Those Treated with Tumor Necrosis Factor Inhibitors? [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/are-there-differences-in-baseline-comorbidities-between-rheumatoid-arthritis-patients-treated-with-abatacept-and-those-treated-with-tumor-necrosis-factor-inhibitors/. Accessed .

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