Session Type: ACR Poster Session C
Session Time: 9:00AM-11:00AM
Background/Purpose: Seropositivity for RF or ACPA is associated with a better short-term effectiveness and drug retention of abatacept (ABA) and rituximab (RTX). Data are very limited concerning the association with long term retention in real life and concerning the association between seropositivity and effectiveness of tocilizumab (TCZ).
Methods: This was a pre-specified sub-group analysis of a multicenter open-label observational study of patients with RA according to 1987 ACR criteria who were initiating RTX, ABA, or TCZ treatment and enrolled in three French Society of Rheumatology prospective registries (AIR for RTX, ORA for ABA, and REGATE for TCZ). Seropositivity was defined by positivity of either RF or anti-CCP. We used a propensity-score approach to adjust for differences in observed factors that might affect both treatment assignment and outcome.
Results: Data on seropositivity were available in 3540 patients out of 4498 patients(87.4%). 72, 76.7 and 80.9% of patients respectively treated with ABA, RTX and TCZ, had RF or ACPA. 3507 patients had a follow-up at 24 months for a total follow-up of 18898 patient-years (RTX, 10545; ABA, 4912; and TCZ, 3441). – Effect of seropositivity on the effectiveness of each drug Drug retention without failure of RTX at 2 years was 68.7[66.4; 71.0]% in seropositive patients and 51.9 [45.6;59.1]% in seronegative patients, HR of discontinuation of 0.56 [0.46;0.69], p< 0.001. Drug retention without failure of RTX at 5 years was 51.0[48.5; 53.5]% in seropositive patients and 30.9 [25.2;38.0]% in seronegative, HR of discontinuation of 0.57 [0.47;0.69], p< 0.001. Drug retention without failure of ABA at 2 years was 41.5[38.0; 45.2]% in seropositive patients and 40.0 [32.8;48.8]% in seronegative patients, HR of discontinuation of 0.92 [0.77;1.11], p=0.41. Drug retention without failure of ABA at 5 years was 22.4 [19.5; 25.7]% in seropositive patients and 17.0 [11.7;24.7]% in seronegative, HR of discontinuation of 0.89 [0.75;1.04], p=0.17. Drug retention without failure of TCZ at 2 years was 63.4[60.4; 66.5]% in seropositive patients and 62.2 [54.5;71.1]% in seronegative patients, HR of discontinuation of 0.99 [0.73;1.33], p=0.93. No patient has reached the 5 year follow- up visit yet. – Impact of seropositivity on the comparative effectiveness between ABA, RTX and TCZ At 2 years, drug retention without failure among seropositive patients was significantly greater with RTX and TCZ than ABA (hazard ratio 1.99 [95% CI: 1.56;2.52], and 1.72 [95% CI: 1.22;2.42], respectively), with no difference between RTX and TCZ. At 2 years, drug retention without failure among seronegative patients was not significantly different between RTX and ABA (HR 1.39 [0.89; 2.17]). Drug retention without failure among seronegative patients was higher with TCZ than ABA (hazard ratio 1.93 [95% CI: 1.22;3.05], with no difference between RTX and TCZ.
Conclusion: Seropositivity for RF or ACPA has no impact on long-term retention for TCZ and ABA, and results in a marked improvement of long-term retention for RTX.
To cite this abstract in AMA style:Gottenberg JE, Morel J, Constantin A, Bardin T, Cantagrel AG, Combe B, Dougados M, Flipo RM, Saraux A, Schaeverbeke T, Sibilia J, Soubrier M, Vittecoq O, Perrodeau E, Ravaud P, Mariette X. Seropositivity for RF or ACPA Predicts Long Term Drug Retention with Rituximab, but Not with Abatacept and Tocilizumab : Long-Term Registry Data in 4498 Patients with Rheumatoid Arthritis [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/seropositivity-for-rf-or-acpa-predicts-long-term-drug-retention-with-rituximab-but-not-with-abatacept-and-tocilizumab-long-term-registry-data-in-4498-patients-with-rheumatoid-arthritis/. Accessed March 23, 2019.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/seropositivity-for-rf-or-acpa-predicts-long-term-drug-retention-with-rituximab-but-not-with-abatacept-and-tocilizumab-long-term-registry-data-in-4498-patients-with-rheumatoid-arthritis/