Journal Article

Retention of subcutaneous abatacept for the treatment of rheumatoid arthritis: real-world results from the ASCORE study: an international 2-year observational study

Alten, Rieke, Sanmartí, Raimon, Flipo, René-Marc, Lozenski, Karissa, Peichl, Peter, Marsal, Sara, Griffiths, Hedley, Connolly, Sean E., Patel, Yusuf, Rauch, Christiane, Chartier, Melanie, Caporali, Roberto, Buch, Maya H., Mariette, Xavier, Bannert, Bettina, Nurmohamed, Michael T.

2022

Overview

Objectives To evaluate retention, efficacy, and safety of subcutaneous (SC) abatacept over 2 years in patients with moderate-to-severe RA in the A batacept S ub C utane O us in R outine clinical practic E (ASCORE) study. Methods Patients with RA who initiated SC abatacept 125 mg once weekly were enrolled in the international, observational, prospective multicentre ASCORE study into biologic-naïve or ≥ 1 prior biologic failure cohorts. Primary endpoint: abatacept retention rate at 2 years. Secondary endpoints: proportion of patients with good/moderate EULAR response rates based on DAS28 (ESR), low disease activity and/or remission according to DAS28 (ESR; ≤ 3.2/ < 2.6), SDAI (≤ 11/ ≤ 3.3), CDAI (≤ 10/ ≤ 2.8), and Boolean criteria. Retention rate by baseline serostatus was evaluated post hoc. Results Overall, 47% of patients remained on abatacept for 2 years, irrespective of treatment line. Higher abatacept retention rates were associated with lower prior biologic exposure. Generally, clinical outcomes showed that the proportion of patients with low disease activity/remission was higher in biologic-naïve patients (vs biologic-failure) and similar in those with 1 and ≥ 2 prior biologic failures. In patients on treatment at 2 years, good/moderate EULAR response rates of ~ 80% were consistently noted irrespective of prior biologic exposure. Across treatment lines, retention was greater in patients with seropositive (vs seronegative) RA. Patients with rheumatoid factor/anti-citrullinated protein antibody single-positive RA who were bio-naïve had higher retention than patients who were bio-experienced. Conclusions In the ASCORE study, SC abatacept retention was 47% at 2 years with good clinical outcomes and was well-tolerated in the real-world setting. Abatacept retention and clinical response rates were higher in patients who received abatacept as an earlier- versus later-line biologic drug treatment and in those with seropositive RA. Trial registration ClinicalTrials.gov, NCT02090556.

• Publisher: Springer International Publishing,Springer Nature B.V
• Subject: Abatacept - therapeutic use / Antirheumatic Agents - therapeutic use / Arthritis, Rheumatoid - chemically induced / Arthritis, Rheumatoid - drug therapy / Biological Products - therapeutic use / Citrulline / Clinical outcomes / Humans / Medicine / Medicine & Public Health / Observational studies / Original / Original Article / Patients / Prospective Studies / Remission / Remission (Medicine) / Response rates / Retention / Rheumatoid arthritis / Rheumatoid factor / Rheumatology / Treatment Outcome