Long-term Experience With Abatacept SC in Routine Clinical Practice

Study Overview
=================
Brief Summary
-----------------
The purpose of this study is to estimate the retention rate of Abatacept SC over 24 months in routine clinical practice, in rheumatoid arthritis patients, in each country involved in the study. The purpose of the UK substudy is to explore whether integrating self-assessment into routine care could maintain tight control (of inflammation/disease activity) and at potentially lower cost resulting in improved health outcomes and cost-effectiveness.

Official Title
-----------------
Long-term Experience With Abatacept SC in Routine Clinical Practice

Conditions
-----------------
Rheumatoid Arthritis

Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Patients ≥18 years old at treatment initiation Patients diagnosed with established moderate to severe active RA as per the 1987 ACR criteria/2010 American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) Rheumatoid Arthritis Classification Criteria Patients naïve of Abatacept IV and who at their physician's discretion are initiated with Abatacept SC. In countries where required (e.g. Germany and Spain), patients naïve of Abatacept IV and who at their physician's discretion have been initiated with Abatacept SC at least 1 month prior to enrollment visit up to 6 months if baseline and disease characteristics data are available For Spanish pharmacogenomic sub-study: Caucasian patient and from European ancestry Patient for whom a collection of blood sample before the initiation of abatacept is possible or available (blood sample was taken in routine practice before the study enrolment) Patient who agreed to participate in this substudy and provide a specific signed Pharmacogenomic Blood RNA informed consent In the UK, the ART substudy will be proposed to all patients enrolled in ASCORE from amendment approval and application date Exclusion Criteria: - Patients who are currently included in any interventional clinical trial in RA

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Cohort 1:<br>RA patients naive of Abatacept and any other biologic agents | |
| Cohort 2:<br>RA patients naive of Abatacept and who previously failed one or more biologic agents | |

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Key Primary: Median time and estimation of treatment retention rate of Rheumatoid arthritis (RA) patients treated with Abatacept subcutaneous (SC) over 24 months in routine clinical practices |  | Up to 24 Months | 
| Co-Primary: Description of how Abatacept SC is prescribed in participating countries for each cohort | Description include concomitant treatments, dosage and adherence to treatment | Up to 24 Months | 
| Co-Primary: Description of the major characteristics of Abatacept SC treated patients (joint population) at treatment initiation | Major characteristics of population of patients (joint population depending on previous prescriptions) include socio-demographic data, medical history, disease history, co-morbidities and clinical measures | Up to 24 Months | 
| Co-Primary: Impact of the Abatacept SC treatment on health status of each population of patients over time as assessed by morbi-mortality criteria and safety | Morbi-mortality criteria include clinical measures, Patient Reported Outcomes (PRO) including self-completion quality of life (QoL) questionnaires and healthcare resource use, incidence of local site injection reaction, incidence of long-term adverse events (AE), withdrawal from study due to AE and Serious Adverse Events (SAE) | Up to 24 Months | 
| Co-Primary: Acceptability of the pre-filled pen device based on questionnaires | Patients using the pre-filled pen will complete questionnaires on overall acceptability of the pre-filled pen device, injection site pain assessment and experience with previous injections | Up to 24 Months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Major determinants of Abatacept SC retention rate | Major determinants including socio-demographic characteristics at treatment initiation, previous biologic treatments, clinical measurements (i.e. Simplified Disease Activity Score based on 28 joints (DAS28), Clinical Disease Activity Index (CDAI), Simple Disease Activity Index (SDAI) and their derived criteria) and PROs such as Health Assessment Questionnaire Disability Index (HAQ-DI) and according to local clinical practices and/or according to local requirements Work Productivity and Activity Impairment Questionnaire:Rheumatoid Arthritis (WPAI:RA), Rheumatoid Arthritis Disease Activity Index (RADAI) or PRO-CLinical Arthritis Activity (PROCLARA) at treatment initiation and/or at studied drug discontinuation | Up to 24 months | 
| Distribution of time-to-discontinuation of Abatacept SC therapy for each major determinant identified |  | Up to 24 months | 
| Time to discontinuation of Abatacept (whatever the formulation, SC or IV) |  | Up to 24 months |