Patterns of Abatacept Utilization in Patients with Rheumatoid Arthritis. Have the Baseline Characteristics of These Patients Changed over Time?

M. Victoria Hernández¹, Carlos Sánchez-Piedra², Jose Inciarte-Mundo¹, Fernando Sanchez-Alonso², Javier Manero³, Rosa Roselló⁴, Eva Pérez-Pampin⁵, Rosa Morla⁶, Carlos Rodriguez-Lozano⁷, Dolores Ruiz-Montesinos⁸, 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, ⁶Arthritis Unit. Rheumatology Department, Hospital Clínic de Barcelona, Barcelona, Spain, ⁷Rheumatology, Hospital de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain, ⁸Rheumatology, Hospital Virgen Macarena, Seville, Spain

Meeting: 2016 ACR/ARHP Annual Meeting

Date of first publication: September 28, 2016

Keywords: Abatacept, healthcare management, patient, registry and rheumatoid arthritis (RA)

Session Information

Date: Tuesday, November 15, 2016

Title: Health Services Research - Poster III

Session Type: ACR Poster Session C

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

Background/Purpose: Abatacept (ABA), a T cell co-stimulation inhibitor, was initially approved by the European Medicine Agency (EMA) for patients with rheumatoid arthritis (RA) who had failed ≥ 1 tumor necrosis factor inhibitor (TNFi), and was available in Europe in 2008. Thereafter EMA also approved ABA for patients failing methotrexate (biologic-naïve patients): this was available in Europe after 2011.These different RA target populations might lead to a change in the RA population treated with ABA over time. Our objective is to analyze differences in the baseline characteristics of RA patients treated with ABA according to calendar year

Methods: All patients from the BIOBADASER 2.0 register with a diagnosis of RA and treated with ABA from January 2008 to December 2014 were selected and divided according to calendar year: 2008-2011 and 2012-2014. Variables analyzed: age; gender; disease duration; number of previous biological agents; disease activity at initiation of biological drug, measured by the DAS-28 score; concomitant treatment with glucocorticoids and synthetic DMARDs; baseline comorbidities (ischemic heart disease, malignancy, diabetes, chronic obstructive pulmonary disease, heart failure and hepatitis B infection); and ABA treatment duration

Results: From January 2008 to December 2014, 252 RA patients treated with ABA were included in the BIOBADASER 2.0 register. Baseline characteristics and distribution by calendar year are shown in Table 1. At baseline, patients treated with abatacept between 2008-2011 had significantly higher basal activity [DAS28 (5.18 (1.46) vs 4.74 (1.57); p 0.037], longer time on ABA [13.44 (12.1) m vs 7.59 (9.1) m; p= 0.039], and fewer patients with ischemic heart disease [1 (0.6%) vs 4 (4.6%), p=0.031], compared with patients treated between 2012-2014. No differences in other parameters were found

Conclusion: Abatacept treatment pattern has not been changed over the time and is being used in patients who failed ≥ 1 biological agent. Initially, patients treated with abatacept had significantly higher baseline DAS28, and a longer time on biological treatment, probably reflecting disease management in Spain Table 1. Differences in basal characteristics and presence of comorbidities of patients treated with abatacept according to calendar year

Years		2008-2011	2012-2014	p
Number of abatacept patients		165	87
Age at initiation of first biologic agent (years), mean (SD)		55.9 (12.5)	58.2 (12.8)	0.171
Women, n (%)		137 (83.0)	71 (81.6)	0.778
Disease duration (years), mean (SD)		12.1 (7.9)	11.9 (8.6)	0.580
Number of previous biologic agents	0	19 (11.5)	8 (9.2)	0.809
	1	45 (27.3)	26 (29.9)
	≥ 2	101 (61.2)	53 (60.9)
Basal DAS28, m (SD)		5.18 (1.46)	4.74 (1.57)	0.037
Concomitant sDMARD (%)	0	65 (39.4)	34 (39.1)	0.587
	1	92 (55.8)	46 (52.9)	0.587
Concomitant corticosteroids (%)		87 (52.7)	47 (54.0)	0.845
Basal comorbidity (%)
Ischemic heart disease		1 (0.6)	4 (4.6)	0.031
Malignancy		3 (1.8)	2 (2.3)	0.795
Diabetes		14 (8.5)	9 (10.3)	0.626
CPOD		9 (5.4)	3 (3.4)	0.477
Heart failure		2 (1.2)	4 (4.6)	0.094
Hepatitis B virus infection		5 (3.0)	5 (5.7)	0.294
Duration of abatacept (months)*		13.4 (12.1)	7.6 (9.1)	0.039

*from abatacept initiation to switch to other biologic

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; R. Morla, None; C. Rodriguez-Lozano, None; D. Ruiz-Montesinos, 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, Morla R, Rodriguez-Lozano C, Ruiz-Montesinos D, Sanmarti R, Gómez-Reino JJ. Patterns of Abatacept Utilization in Patients with Rheumatoid Arthritis. Have the Baseline Characteristics of These Patients Changed over Time? [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/patterns-of-abatacept-utilization-in-patients-with-rheumatoid-arthritis-have-the-baseline-characteristics-of-these-patients-changed-over-time/. Accessed .

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