Clinical, radiographic and functional efficacy of abatacept in routine care for rheumatoid arthritis patients: Abatacept Leading Trial for RA on Imaging Remission (ALTAIR) study.

OBJECTIVES

To investigate the efficacy and safety of abatacept for treating patients with rheumatoid arthritis (RA) in routine clinical practice and to determine the prognostic factors affecting clinical outcomes.

METHODS

We performed a retrospective study of 194 RA patients treated with abatacept. Clinical outcomes at 1 year after the treatment were assessed. Joint damage was assessed by the van der Heijde-modified total Sharp score (mTSS).

RESULTS

Of the 194 patients, abatacept was discontinued in 51 patients, resulting in a retention rate at week 52 of 73.7%. At week 52, 23.7% of patients achieved clinical remission (SDAI ≤3.3). Lower SDAI and higher RF titre at baseline were the prognostic factor for SDAI at 52 weeks. Structural remission (ΔmTSS ≤0.5) was achieved in 73.4% of patients. However, clinical relevant radiographic progression which was defined as an increase in ΔmTSS >3 in a year, occurred in 7.6% of patients. Likewise, rapid radiological progression, which was defined as an increase in ΔmTSS >5 in a year, was observed in 6.4% of patients. 16.5% of patients achieved comprehensive disease remission, which was defined as SDAI ≤3.3, HAQ-DI ≤0.5, ΔmTSS ≤0.5, while 22.4% of patients achieved comprehensive disease control (CDC), which was defined as SDAI ≤11.0, HAQ-DI ≤0.5, ΔmTSS ≤0.5.

CONCLUSIONS

The present results confirm that abatacept is effective and safe in routine clinical practice. It is possible that abatacept is more effective in seropositive RA patients with significant immunological abnormality.