ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 553

Body Mass Index Does Not Influence the Efficacy of Abatacept in Patients with RA Who Are Biologic Naïve: 6-Month Results from a Real-World, International, Prospective Study

R Alten1, HG Nüßlein2, M Galeazzi3, H-M Lorenz4, X Mariette5, A Cantagrel6, M Chartier7, G Desachy8, C Poncet9, C Rauch10 and M Le Bars11, 1Schlosspark-Klinik University Medicine, Berlin, Germany, 2University Erlangen, Nürnberg, Germany, 3University of Siena, Siena, Italy, 4University Hospital, Heidelberg, Germany, 5Université Paris-Sud, Paris, France, 6Purpan Hospital, Toulouse, France, 7Chiltern International, Neuilly, France, 8Excelya, Boulogne-Billancourt, France, 9Docs International, Nanterre, France, 10Bristol-Myers Squibb, Munich, Germany, 11Bristol-Myers Squibb, Rueil-Malmaison, France

Meeting: ACR/ARHP Annual Meeting 2015

Date of first publication: September 29, 2015

Keywords:

Session Information

Date: Sunday, November 8, 2015

Title: Rheumatoid Arthritis - Small Molecules, Biologics and Gene Therapy Poster I

Session Type: ACR Poster Session A

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

Background/Purpose:
In RA, obesity may negatively affect clinical
response to anti-TNF agents.1 In contrast, real-world data show abatacept
efficacy and retention are unaffected by BMI in patients (pts) with prior
biologic failure.2,3 Here, response to abatacept was assessed after
6 months, according to BMI, in biologic-naïve pts enrolled in the ACTION study. Methods: ACTION is a 2-year, international, multicenter, prospective,
observational study evaluating retention and effectiveness of IV abatacept in pts
with RA. In this 6-month analysis of biologic-naïve pts enrolled in ACTION, baseline
characteristics and clinical response were compared by BMI subgroup: underweight/normal
(<25 kg/m2), overweight (25–<30 kg/m2) and obese (≥30 kg/m2).
Time to abatacept discontinuation (overall and due to efficacy and safety) was
estimated using Kaplan–Meier survival analysis and compared using log-rank
tests. Results: BMI was reported in 643/672 (96%)
pts: 264/643 (41%) were underweight/normal, 224/643 (35%) overweight and 155/643
(24%) obese. Higher baseline BMI was associated with more active disease (mean
[95% CI] DAS28 [CRP] [derived] 4.6 [4.5, 4.7], 4.8 [4.7, 5.0] and 5.1 [4.9,
5.2] for BMI <25, 25–<30 and ≥30 kg/m2, respectively), possibly
due to a relation between fat tissue and chronic inflammation4, and
numerically more women (74, 66 and 81%), more metabolic disorders (22, 29 and
46%) and fewer RF positive (77, 68 and 67%) and anti-cyclic citrullinated
peptide positive (71, 63 and 63%) pts (for BMI <25, 25–30 and ≥30 kg/m2, respectively). Overall retention rates at 6
months (Kaplan–Meier analysis) did not differ across groups (84, 89 and 87%, for BMI <25,
25–<30 and ≥30 kg/m2, respectively; log-rank
p=0.290); no significant differences between groups were
observed in discontinuation rates due to safety (log-rank p=0.683) or efficacy
(log-rank p=0.516). After adjustment for baseline characteristics, BMI was
still not significantly associated with risk of discontinuation (reference BMI
<25 kg/m2; HR [95% CI] 0.46 [0.22, 0.99] and 0.69 [0.34, 1.41] for
BMI 25–<30 and ≥30 kg/m2, respectively; figure). No
significant differences in the percentage of pts in EULAR moderate or good
response and no response were observed by BMI (80.7, 86.1 and 77.0% and 19.3,
13.9 and 23.0% of pts with BMI <25, 25–<30 and ≥30 kg/m2,
respectively; p=0.178). 

Conclusion: BMI does not impact abatacept retention or clinical
response in biologic-naïve pts with RA. Unlike anti-TNFs, obesity is not a risk
factor for reduced efficacy of abatacept. These results
are similar to those observed in real-world studies in pts with prior biologic failure.2,3

1.   
Gremese E, et al. Arthritis Care Res
2013;65:94–100.

2.   
Iannone F, et al. Ann Rheum Dis
2014;73(Suppl 2):498.

3.   
Nüßlein H, et al. Arthritis Rheum
2014;66(Suppl.11):S1088.

4.   
Ferraccioli G, et al. Swiss Med
Wkly 2011;141:w13211.  

Disclosure: R. Alten, Bristol-Myers Squibb, 2,Bristol-Myers Squibb, 5,Bristol-Myers Squibb, 8; H. Nüßlein, Bristol-Myers Squibb, Abbvie, Chugai, UCB, Wyeth, Pfizer, MSD, Novartis and Roche, 5,Bristol-Myers Squibb, Abbvie, Chugai, UCB, Wyeth, Pfizer, MSD, Novartis and Roche, 8; M. Galeazzi, None; H. M. Lorenz, Abbvie, BMS, Roche-Chugai, UCB, MSD, GSK, SOBI, Medac, Novartis, Janssen-Cilag, Astra-Zeneca, Pfizer, Actelion, 5,Abbvie, BMS, Roche-Chugai, UCB, MSD, GSK, SOBI, Medac, Novartis, Janssen-Cilag, Astra-Zeneca, Pfizer, Actelion, 8; X. Mariette, BMS, GSK, Pfizer, UCB, 8; A. Cantagrel, UCB, Pfizer, 2,Abbvie, BMS, Lilly, MSD, Novartis, Pfizer, Roche, 5; M. Chartier, None; G. Desachy, Bristol-Myers Squibb, 1,Bristol-Myers Squibb, 3; C. Poncet, Bristol-Myers Squibb, 9; C. Rauch, Bristol-Myers Squibb, 1,Bristol-Myers Squibb, 3; M. Le Bars, Bristol-Myers Squibb, 1,Bristol-Myers Squibb, 3.

To cite this abstract in AMA style:

Alten R, Nüßlein H, Galeazzi M, Lorenz HM, Mariette X, Cantagrel A, Chartier M, Desachy G, Poncet C, Rauch C, Le Bars M. Body Mass Index Does Not Influence the Efficacy of Abatacept in Patients with RA Who Are Biologic Naïve: 6-Month Results from a Real-World, International, Prospective Study [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/body-mass-index-does-not-influence-the-efficacy-of-abatacept-in-patients-with-ra-who-are-biologic-naive-6-month-results-from-a-real-world-international-prospective-study/. Accessed .

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