AB0207 ANALYSIS OF ABATACEPT TREATMENT RETENTION AND EFFICACY ACCORDING TO DISEASE DURATION AND TREATMENT LINE IN A REAL-WORLD SETTING
Authors: R. Alten, X. Mariette, R. M. Flipo, R. Caporali, M. H. Buch, Y. Patel, R. Sanmartí, S. Marsal, M. T. Nurmohamed, H. Griffiths, P. Peichl, B. Bannert, A. Forster, M. Chartier, Y. Elbez, C. Rauch, V. Khaychuk, K. Lozenski
Journal: Annals of the Rheumatic Diseases (2021)

Background: Longer disease duration and greater number of prior DMARDs have been associated with lower treatment efficacy in patients with RA. 1 Abatacept is a biologic (b)DMARD for treatment of moderate-to-severe RA and is available in SC formulation, which may offer convenience benefits with efficacy similar to IV administration. 2 ASCORE ( A batacept S ub C utane O us in R outine Clinical Practic E ; NCT02090556 ) was a 2-year, observational, prospective, multicentre study of SC abatacept for treatment of RA in routine clinical practice. 3 Objectives: This post hoc analysis was conducted to determine if retention and efficacy of abatacept were impacted by disease duration and/or treatment line. Methods: Eligible patients, aged ≥18 years, with active moderate-to-severe RA (ACR/EULAR 2010 criteria) who were IV abatacept-naive and initiated SC abatacept 125 mg once weekly, were enrolled into two cohorts: bDMARD-naive patients and those with ≥1 prior bDMARD treatment failure. This post hoc analysis evaluated abatacept retention using Kaplan-Meier estimates, as well as disease activity scores (DAS28 [ESR]), CDAI and SDAI in patients with disease duration of ≤2, 3–5, 6–10 or &gt;10 years, and in patients taking abatacept as first-line or ≥ second-line treatment. Results: Table 1 shows baseline (BL) characteristics. Mean age increased with disease duration; other characteristics were comparable across groups. Retention proportions (95% CIs) at Month 24 were 0.50 (0.4, 0.5), 0.47 (0.4, 0.5), 0.51 (0.5, 0.5) and 0.46 (0.4, 0.5) in the ≤2, 3–5, 6–10 and &gt;10 years’ duration groups, respectively. Proportion of patients (95% CI) with ≤2 years’ duration retaining treatment at Month 24 were 0.51 (0.4, 0.6) among those using abatacept as first-line treatment and 0.44 (0.3, 0.6) among those using abatacept as a ≥ second-line treatment (Figure 1). Proportions (95% CI) at Month 24 were 0.51 (0.5, 0.6), 0.57 (0.5, 0.6) and 0.52 (0.5, 0.6) in first-line patients and 0.43 (0.4, 0.5), 0.48 (0.4, 0.5) and 0.44 (0.4, 0.5) in ≥ second-line patients in the 3–5, 6–10 and &gt;10 years’ duration groups, respectively. Mean (SE) changes from BL in DAS28 (ESR) at Month 24 were –2.12 (0.205), –1.86 (0.151), –2.07 (0.140) and –2.05 (0.115) in the ≤2, 3–5, 6–10 and &gt;10 years’ duration groups, respectively; respective mean (SE) changes in CDAI were –18.74 (1.604), –15.60 (1.099), –18.50 (1.038) and –17.68 (0.850); and respective mean (SE) changes in SDAI were –19.10 (1.873), –15.72 (1.345), –19.54 (1.103) and –17.07 (0.939). Conclusion: In this post hoc analysis of the real-world ASCORE trial, patients with RA receiving abatacept in clinical practice as first-line therapy had better retention versus those receiving it as a ≥ second-line treatment, regardless of disease duration at BL. Retention rates were similar across disease duration subgroups. Improvements in disease activity were seen in all duration subgroups, without consistently greater or lesser improvement seen with longer disease duration. References: [1]Aletaha D, et al. Ann Rheum Dis 2019;78:1609–1615. [2]Genovese MC, et al. Arthritis Rheumatol 2011;63:2854–2864. [3]Alten R, et al. Ann Rheum Dis 2019;78(suppl 2):A1639. Table 1. BL characteristics (n=2872) RA disease duration, years ≤2 (n=338 ) 3–5 (n=655 ) 6–10 (n=686 ) &gt;10 (n=1193 ) Age, years n 338 655 686 1193 Mean (SD) 55.2 (12.8) 55.6 (12.7) 56.9 (13.0) 59.9 (12.2) Weight, kg n 327 629 665 1150 Mean (SD) 75.3 (18.1) 76.4 (19.0) 74.7 (17.4) 72.9 (16.0) DAS28 (ESR ) n 247 439 441 743 Mean (SD) 5.2 (1.3) 4.9 (1.3) 5 (1.2) 5.1 (1.3) DAS28 (CRP ) n 267 460 467 799 Mean (SD) 4.7 (1.2) 4.6 (1.2) 4.7 (1.1) 4.7 (1.2) CDAI n 269 477 474 805 Mean (SD) 26.9 (12.7) 25.3 (12.2) 26.8 (12.4) 26.6 (12.2) SDAI n 255 448 445 749 Mean (SD) 28.3 (13.3) 26.8 (12.9) 27.9 (12.6) 28.0 (12.7) RF status, n (% ) RF+ 159 (47.0) 342 (52.2) 345 (50.3) 597 (50.0) RF– 103 (30.5) 152 (23.2) 158 (23.0) 215 (18.0) Anti-CCP status, n (% ) Anti-CCP+ 165 (48.8) 332 (50.7) 333 (48.5) 516 (43.3) Anti-CCP– 89 (26.3) 126 (19.2) 137 (20.0) 175 (14.7) Patients with missing duration of disease are excluded. CCP=cyclic citrullinated peptide. Acknowledgements: Professional medical writing and editorial assistance was provided by Rob Coover, MPH, at Caudex and was funded by Bristol Myers Squibb. This study was funded by Bristol Myers Squibb. Disclosure of Interests: Rieke Alten Speakers bureau: AbbVie, Bristol Myers Squibb, Gilead, Janssen, Lilly, Pfizer, Consultant of: AbbVie, Bristol Myers Squibb, Gilead, Janssen, Lilly, Pfizer, Grant/research support from: AbbVie, Bristol Myers Squibb, Gilead, Janssen, Lilly, Pfizer, Xavier Mariette Consultant of: Bristol Myers Squibb, Galapagos, Gilead, GlaxoSmithKline, Janssen, Pfizer, UCB, Rene-Marc Flipo Speakers bureau: AbbVie, Bristol Myers Squibb, Janssen, Lilly, Medac, Merck Sharp &amp; Dohme, Novartis, Pfizer, Roche-Chugai, Grant/research support from: Amgen, Janssen, Novartis, Pfizer, Roberto Caporali Speakers bureau: AbbVie, Amgen, Bristol Myers Squibb, Celltrion, Fresenius Kabi, Galapagos, Gilead, Lilly, Merck Sharp &amp; Dohme, Pfizer, Roche, Samsung Bioepis, Sanofi, UCB, Consultant of: Galapagos, Gilead, Janssen, Lilly, Merck Sharp &amp; Dohme, Maya H Buch Speakers bureau: AbbVie, Consultant of: AbbVie, Eli Lilly, Gilead, Merck Serono, Pfizer, Roche, Sanofi, Grant/research support from: Gilead, Pfizer, Roche, UCB, Yusuf Patel: None declared, Raimón Sanmartí Speakers bureau: AbbVie, Bristol Myers Squibb, Gebro, Janssen, Lilly, Merck Sharp &amp; Dohme, Pfizer, Roche, Sanofi, Consultant of: AbbVie, Bristol Myers Squibb, Gebro, Lilly, Merck Sharp &amp; Dohme, Pfizer, Roche, Sanofi, Grant/research support from: Bristol Myers Squibb, Merck Sharp &amp; Dohme, Pfizer, Sara Marsal Speakers bureau: Bristol Myers Squibb, Celgene, Pfizer, Roche, Sanofi, UCB, Consultant of: AbbVie, Bristol Myers Squibb, Celgene, Galapagos, Merck Sharp &amp; Dohme, Pfizer, Roche, Sanofi, UCB, Grant/research support from: AbbVie, Bristol Myers Squibb, Celgene, Janssen, Merck Sharp &amp; Dohme, Novartis, Pfizer, Roche, Sanofi, UCB, M.T. Nurmohamed Speakers bureau: AbbVie, Bristol Myers Squibb, Eli Lilly, Roche, Sanofi, Consultant of: AbbVie, Celgene, Celltrion, Eli Lilly, Janssen, Grant/research support from: AbbVie, Bristol Myers Squibb, Celgene, Eli Lilly, Janssen, Merck Sharp &amp; Dohme, Mundipharma, Novartis, Pfizer, Roche, Sanofi, Hedley Griffiths Consultant of: AbbVie, Gilead, Janssen, Novartis, Peter Peichl: None declared, Bettina Bannert: None declared, Adrian Forster: None declared, Melanie Chartier Shareholder of: Bristol Myers Squibb, Employee of: Bristol Myers Squibb, Yedid Elbez Consultant of: Bristol Myers Squibb, Christiane Rauch Shareholder of: Bristol Myers Squibb, Employee of: Bristol Myers Squibb, Vadim Khaychuk Shareholder of: Bristol Myers Squibb, Employee of: Bristol Myers Squibb, Karissa Lozenski Shareholder of: Bristol Myers Squibb, Employee of: Bristol Myers Squibb