Background/Purpose: Abatacept is approved for use with or without methotrexate (MTX). The purpose of this study was to clarify the inhibitory effect of abatacept on joint damage and its clinical efficacy in rheumatoid arthritis (RA) patients with or without concomitant MTX in routine clinical practice.

Methods: A retrospective multicenter study was conducted. Patients with RA who underwent abatacept treatment for 52 weeks were analyzed.

Results: Forty eight chronologically consecutive patients in the hospitals (4 males, 44 women, mean age of 62.8 years old, mean disease duration of 12.0 years, mean DAS28-CRP of 4.0, rate of MTX use of 56.3% ) with active RA who started abatacept therapy were analyzed. All patients fulfilled the ACR 1987 revised criteria. Five patients were withdrawn during 1 year due to insufficient efficacy. The retention rates at 1 year of patients with or without concomitant MTX were 88.9% and 90.5%, respectively. At week 52, 37% and 35% of patients with or without concomitant MTX achieved clinical remission, respectively. There was no significant difference in achievement of remission by the concomitant use of MTX.  The ΔmTSS decreased significantly from 9.44 at baseline to 0.86 at week 52. Rates of the structural remission [ΔmTSS: 0.5 or below] was achieved in patients with and without concomitant MTX were 58.3% and 68.4%, respectively. Thus, the radiographic changes were not significantly affected by the concomitant use of MTX.

Conclusion: Abatacept showed good clinical and radiographic effects for RA patients with or without concomitant MTX in routine clinical practice.

ACR Meeting Abstracts - https://acrabstracts.org/abstract/inhibitory-effect-of-abatacept-on-joint-damage-in-rheumatoid-arthritis-patients-with-or-without-concomitant-methotrexate-a-retrospective-multicenter-analysis-of-12-months-of-abatacept-treatment-in-ro/