Predictive factors for structural remission using abatacept: Results from the ABROAD study

Abstract

Objective: To investigate the effect of abatacept (ABA) on preventing joint destruction in biological disease-modifying anti-rheumatic drug (bDMARD)-naïve rheumatoid arthritis (RA) patients in real-world clinical practice.

Patients and methods: RA patients were collected from the ABROAD (ABatacept Research Outcomes as a First-line Biological Agent in the Real WorlD) study cohort. They had moderate or high disease activity and were treated with ABA as a first-line bDMARD. Radiographic change between baseline and 1 year after ABA treatment was assessed with the van der Heijde’s modified Total Sharp Score (mTSS). Predictive factors for structural remission (St-REM), defined as ΔmTSS ≤0.5/year, were determined.

Results: Among 118 patients, 81 (67.5%) achieved St-REM. Disease duration <3 years (odds ratio (OR) = 3.152, p = .007) and slower radiographic progression (shown as ‘baseline mTSS/year <3’, OR = 3.727, p = .004) were independently significant baseline predictive factors for St-REM irrespective of age and sex. St-REM prevalence increased significantly if clinical remission based on the Simplified Disease Activity Index was achieved at least once until 24 weeks after ABA treatment.

Conclusion: Shorter disease duration, smaller radiographic progression at baseline, and rapid clinical response were predictive factors for sustained St-REM after ABA therapy in bDMARD-naïve RA patients.

Keywords:

• Abatacept
• first biological DMARDs
• radiographic progression
• rheumatoid arthritis

Acknowledgements

The authors acknowledge the patients and members of the ABROAD Study Group: K. Maeda, H. Nakahara, S. Higa, Y. Hamano, M. Nishide, S. Nozaki (NTT West Osaka Hospital); A. Yamamoto, Y. Kukita, T. Senoo, H. Nagahara (Kyoto Prefectural University of Medicine); H. Hashimoto, Rinku Hashimoto Rheumatology Orthopaedics; A. Yokota (Yokota Clinic); K. Miki, Amagasaki Central Hospital; N. Shinmyo, T. Fujimura (Kashiba Asahigaoka Hospital); H. Goto, M. Tada, T. Koike, Y. Sugioka, T. Okano (Osaka City University); T. Fujimoto (Nara Medical University); Y. Ozaki, Y. Son (Kansai Medical University); M. Kitano (Hyogo College of Medicine); S. Irimajiri (Rinku General Medical Center); T. Hidaka (Zenjinkai Shimin-no-Mori Hospital); Y. Nozaki, M. Funauchi, S. Hino, M. Sugiyama, T. Shiga (Kinki University School of Medicine); T. Kuroiwa (Yukioka Hospital); I. Yoshii (Yoshii Hospital); M. Hashimoto, N. Yamakawa (Kyoto University); K. Hatta, T. Azuma, Tenri Hospital; T. Igawa, K. Inoue, Osaka Rehabilitation Hospital; T. Takeuchi, Hayaishi Hospital; M. Tanaka, Kanazawa Medical University; K. Higami, Higami Hospital; M. Namiki, T. Yamazaki (Takarazuka City Hospital); T. Nakatani, T. Saito (Kishiwada City Hospital); Y. Imura, T. Nakajima (Osaka Red Cross Hospital); S. Namiuchi, K. Akashi, M. Nakata (Osaka Saiseikai Nakatsu Hospital); T. Takeuchi (Osaka Medical College); A. Omoto (Japanese Red Cross Kyoto Daiichi Hospital); A. Nanpei (Osaka Rosai Hospital); S. Watanabe (Watanabe Orthopaedic Clinic); K. Ushio (Ushio Orthopaedic Clinic); Y. Hideki (Nijoekimae Clinic); S. Oshima (Osaka Minami Medical Center); S. Kashiwagi (Amagasaki Iryou-Seikyou Hospital); H. Yokoyama (Yokoyama Orthopaedic Clinic); M. Morimoto (Kobe City Medical Center West Hospital); Y. Uesugi (Saiseikai Noe Hospital); S. Mokuda (M. Onishi, Dogo Spa Hospital); H. Yanagita (National Hospital Organization Utano Hospital); K. Sugimoto (Fukui General Hospital); T. Sasaki (Nishinomiya Watanabe Hospital); and A. Hashiramoto (Kobe University). We thank Arshad Makhdum, PhD, from Edanz Group (www.edanzediting.com/ac) for editing a draft of this manuscript.

Conflict of interest

K. Murakami has received speaking fees, and/or consulting fees from Eisai Co. Ltd, Chugai Pharmaceutical Co. Ltd., Pfizer Japan Inc., Bristol-Myers Squibb, Mitsubishi-Tanabe Pharma Corporation, UCB, Daiichi Sankyo Co. Ltd. and Astellas Pharma Inc. M.S has received speaking fees, and/or consulting fees from Chugai Pharmaceutical Co. Ltd., UCB, Ono Pharmaceutical Co., Ltd. and Bristol-Myers Squibb. T.F. has received a research grant and/or speaker fee from Pfizer Japan Inc., Ono Pharmaceutical Co., Ltd., Daiichi Sankyo Co. Ltd., Mitsubishi-Tanabe Pharma Corporation, Eisai Co. Ltd., AbbVie GK, and Astellas Pharma Inc. K. Matsui has received speaking fees from Chugai Pharmaceutical Co. Ltd., Pfizer Japan Inc., Bristol-Myers Squibb, Mitsubishi-Tanabe Pharma Corporation and Astellas Pharma Inc. S.M. has received grants from Chugai Pharmaceutical Co. Ltd. and Bristol-Myers Squibb; lecture fees from Eisai Co. Ltd, Chugai Pharmaceutical Co. Ltd., Bristol-Myers Squibb and Daiichi Sankyo Co. Ltd. K.O. has received speaking fees or consulting fees from Eisai Co. Ltd, Chugai Pharmaceutical Co. Ltd., Pfizer Japan Inc., Bristol-Myers Squibb, Mitsubishi-Tanabe Pharma Corporation and Asahi Kasei Pharma Corporation. Y.K. has received grants from Chugai Pharmaceutical Co. Ltd., Pfizer Japan Inc., AbbVie GK, Eisai Co., Ltd., Mitsubishi Tanabe, Astellas Pharma Inc., Asahi Kasei Pharma Co., Daiichi Sankyo Co. Ltd., AYUMI Pharmaceutical Corporation; lecture fees and/or consulting fees from Eisai Co., Ltd., AbbVie GK, Chugai Pharmaceutical Co. Ltd., Janssen Pharmaceutical K.K., Pfizer Japan Inc., Mitsubishi-Tanabe Pharma Corporation, Takeda Pharmaceutical Company Ltd., Bristol-Myers Squibb, Astellas Pharma Inc., UCB, Asahi Kasei Pharma Co., and Daiichi Sankyo Co. Ltd. N. Nishimoto has received research grants from Chugai Pharmaceutical Co. Ltd., Eisai Co. Ltd., AYUMI Pharmaceutical Corporation, royalties from Chugai Pharmaceutical Co. Ltd., consultant fees from Chugai Pharmaceutical Co. Ltd., lecture fees from Chugai Pharmaceutical Co. Ltd., AYUMI Pharmaceutical Corporation, Eisai Co. Ltd., AbbVie Inc., Mitsubishi-Tanabe Pharma Corporation, Novartis Pharma K.K., Janssen Pharmaceutical K.K., and Astellas Pharma Inc. T.M. has received grants from Chugai Pharmaceutical Co. Ltd., Pfizer Japan Inc., Bristol-Myers Squibb, Mitsubishi-Tanabe Pharma Corporation, Takeda Pharmaceutical Company Ltd., Astellas Pharma Inc., Asahi Kasei Pharma Co., Daiichi Sankyo Co. Ltd., AYUMI Pharmaceutical Corporation and Nippon Kayaku Co., Ltd.; lecture fees from Eisai Co. Ltd, Chugai Pharmaceutical Co. Ltd., Pfizer Japan Inc., Bristol-Myers Squibb, Mitsubishi-Tanabe Pharma Corporation, Astellas Pharma Inc., Asahi Kasei Pharma Co. and AYUMI Pharmaceutical Corporation. H.S. has received grants from Eisai Co. Ltd, Chugai Pharmaceutical Co. Ltd., Pfizer Japan Inc., Bristol-Myers Squibb, AbbVie GK, Mitsubishi-Tanabe Pharma Corporation, Asahi Kasei Pharma Co., AYUMI Pharmaceutical Corporation and Astellas Pharma Inc.; lecture fees from Eisai Co. Ltd, Janssen Pharmaceutical K.K., Chugai Pharmaceutical Co. Ltd., Pfizer Japan Inc., Bristol-Myers Squibb, Mitsubishi-Tanabe Pharma Corporation, Daiichi Sankyo Co. Ltd., Asahi Kasei Pharma Co., AYUMI Pharmaceutical Corporation and Astellas Pharma Inc.

Additional information

Funding

This study was funded by Bristol-Myers Squibb.