AB0282 CLINICAL EFFECTIVENESS OF ABATACEPT MONOTHERAPY OR ABATACEPT CONCOMITANT METHOTREXATE THERAPY IN RHEUMATOID ARTHRITIS PATIENTS PREVIOUSLY TREATED WITH BIOLOGICAL DISEASE-MODIFYING ANTIRHEUMATIC DRUGS (bDMARDs)

Concomitant use of methotrexate (MTX) in abatacept (ABA) therapy is associated with good clinical response in patients with rheumatoid arthritis (RA) who are naïve to biological disease-modifying antirheumatic drugs (bDMARDs)1,2. However, it is unclear when abatacept is used in patients with prior bDMARDs use3.We compared the effectiveness of abatacept monotherapy versus abatacept combined with methotrexate therapy in rheumatoid arthritis patients with prior bDMARDs use.Retrospective cohorts study. Rheumatoid arthritis patients treated with abatacept between 2009 and 2019 (n=86). Socio-demographic, clinical and pharmacological characteristics of patients were collected. We compared clinical effectiveness between ABA monotherapy patients (n=49) and abatacept concomitant methotrexate therapy patients (n=37), prior treated with bDMARDs. The effectiveness was measured according toThe European League Against Rheumatism(EULAR) response withDisease Activity Score(DAS28) like satisfactory (DAS28<3.2) or unsatisfactory (DAS28≥3.2), after 12 months of ABA therapy in RA patients.49 RA patients have been evaluated in ABA monotherapy group; 83.67% (41/49) were women, disease duration was 16 (10-22) years and age of RA diagnosis was 48 (38.25-57.00). Concomitants glucocorticoids were administrated in 81.63% (40/49). Rheumatoid factor (RF) was positive in 75.51% (37/49) patients and cyclic citrullinated peptide antibodies (ACPA) in 71.43% (35/49). At 12 months, 40.82% (20/49) of patients had satisfactory EULAR response.In the combination therapy group, the age of RA diagnosis was 42.5 (35.75-53.50), 75.68% (28/37) were women and the disease duration was 12 (7-21) years. 89.19% (33/37) had concomitants glucocorticoids and the RF was positive in 72.97% (27/37) of patients. EULAR response was satisfactory at 12 months in 43.24% (16/37) of patients. No difference in treatment effectiveness was found in patients receiving abatacept in combination therapy with MTX compared with ABA monotherapy (p=0.829; IC95=0.35-2.35). Abatacept plus methotrexate therapy did not improve the effectiveness in rheumatoid arthritis patients with prior bDMARDs use, compared with abatacept monotherapy. [1]Genovese M, Schiff M, Luggen M, Becker J, Aranda R, Teng J, et al. Efficacy and safety of the selective co-stimulation modulator abatacept following 2 years of treatment in patients with rheumatoid arthritis and an inadequate response to anti-tumour necrosis factor therapy. Annals of the rheumatic diseases. 2008;67(4):547-54. [2]Smolen JS, Landewe RBM, Bijlsma JWJ, Burmester GR, Dougados M, Kerschbaumer A, et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2019 update. Ann Rheum Dis. 2020. [3]Walker UA, Jaeger VK, Chatzidionysiou K, Hetland ML, Hauge E-M, Pavelka K, et al. Rituximab done: what’s next in rheumatoid arthritis? A European observational longitudinal study assessing the effectiveness of biologics after rituximab treatment in rheumatoid arthritis. Rheumatology. 2016;55(2):230-6None declared