FRI0205 Gender and previous treatment influence outcomes from abatacept in a 5-year rheumatoid arthritis cohort
Authors: S. Lindblad, L. Stawiarz
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Abatacept is a novel biological T-cell modulation drug used in RA. Data on patient characteristics, diagnosis, preceding treatment and outcomes of abatacept had been collected since approval in the national Swedish Rheumatology Quality register (SRQ). <h3>Objectives</h3> To evaluate the effects of abatacept in clinical practice five years after approval in a cohort of rheumatoid arthritis patients. <h3>Methods</h3> Observational data from the SRQ was collected for the period from April 1st, 2006 to September 30th, 2011.Survival analysis (Kaplan Meier curves) with right censoring and log-rank test of equality across strata was performed. Comparisons between all pairs of curves with Tukey-Kramer multiple-comparison adjustments were applied. <h3>Results</h3> There were 789 patients who started abatacept treatment between April 2006 and September 2011. 614 patients (487 females, 79.3%) had RA diagnosis with median (min-max) “age at start of abatacept” of 60 years (23-89) and median “disease duration” of 11 years (0.1-67). Median “time since first given biological treatment to abatacept start” was 3.4 years (0-11). Median “abatacept treatment time” was 0.9 years (0-5). Abatacept was used as a first biological treatment in 68 patients (11%), after one or two previous and unique biological drugs in 341 (56%) patients, after three or more unique biological drugs in 205 (33%) patients. After 1, 2, 3 and 4 years drug survival was 80%, 73%, 63% and 63% respectively in bio-naïve patients, 64%, 51%, 49% and 46% in patients with 1-2 previous biological treatments and 57%, 41%, 30% and 30% in patients with three or more previous biological treatments. Bio-naïve patients had significantly longer drug survival time than patients with three or more previous treatments (p=0.006), and patients with 1-2 previous biological treatments had longer drug survival time than patients with three or more previous treatments. Disease activity outcomes were measured as DAS28 before treatment and after 3, 6 and 12 months of treatment. A per-protocol analysis was used. There was significant reduction of DAS28 at all time points compared with baseline. Median DAS28 at baseline was 5.5, at 3 months 4.5, at 6 months 4.3 and at 12 months 3.9. The effect of abatacept expressed by DAS28 was significantly better in men than in women at all time points except for 6 months. A longer drug survival was found also in men compared to women (p=0.05). At 1, 2, 3 and 4 years respectively drug survival was 68%, 59%, 54% and 51% in men and 62%, 47%, 40% and 39% in women. <h3>Conclusions</h3> In the cohort of 614 RApatients starting abatacept treatment during 2006 – 2011, drug survival time was longer for bio-naïve patients compared to patients treated with previous biological drugs. A gender difference in favour of men was seen in the reduction of disease activity as well as in abatacept drug survival. <h3>Disclosure of Interest</h3> S. Lindblad Grant/Research support from: BristolMyersSquibb as an unrestricted research grant, L. Stawiarz: None Declared