Choy Ernest, Groves Lara, Sugrue Daniel, Hurst Michael, Houghton John, Venkatachalam Srinivasan, Patel Yusuf I, Maxwell James R, Pollock Kevin G, Henning Sadie
CREATE Centre, Division of Infection and Immunity, Cardiff University School of Medicine, Wales, UK.
Cardiff and Vale University Health Board, Cardiff, Wales, UK.
BMC Rheumatol. 2021 Feb 4;5(1):3. doi: 10.1186/s41927-020-00173-0.
Rheumatoid arthritis (RA) is an inflammatory autoimmune disease that causes chronic synovitis, resulting in progressive joint destruction and functional disability and affects approximately 400,000 people in the UK. This real-world study aimed to describe the characteristics, treatment patterns and clinical outcomes of patients who received abatacept in UK clinical practice.
This was a multi-centre, retrospective, observational study of patients with RA treated with abatacept at four UK centres between 01 January 2013 and 31 December 2017. Data were collected from medical records of each patient from the index date (date of first bDMARD initiation) until the most recent visit, death or end of study (31 December 2017).
In total, 213 patients were included in the study. Patients received up to eight lines of therapy (LOTs). Treatment with abatacept, or any other bDMARD, was associated with reductions in DAS28-ESR and DAS28-CRP scores at 6 and 12 months. The distribution of EULAR responses (good/moderate/no response) tended to be more favourable for patients when receiving abatacept than when receiving other bDMARDs (22.8%/41.3%/35.9% versus 16.6%/41.4%/42.1% at 6 months, and 27.9%/36.1%/36.1% versus 21.2%/34.5%/44.2% at 12 months). Patients receiving abatacept at LOT1 (n = 68) spent significantly longer on treatment compared with patients receiving other bDMARDs (53.4 vs. 17.4 months; p< 0.01); a similar trend was observed for LOT2. Among patients who discontinued after 6 months, a greater proportion experienced infection requiring antibiotics when receiving other bDMARDs compared to those receiving abatacept.
RA patients who received bDMARDs, including abatacept, experienced reduced disease activity. When receiving abatacept as first or second line of therapy, patients persisted with treatment significantly longer than those receiving other bDMARDs.
类风湿性关节炎（RA）是一种炎症性自身免疫性疾病，可导致慢性滑膜炎，进而造成进行性关节破坏和功能残疾，在英国约有40万人受其影响。这项真实世界研究旨在描述在英国临床实践中接受阿巴西普治疗的患者的特征、治疗模式和临床结局。
这是一项多中心、回顾性观察研究，研究对象为2013年1月1日至2017年12月31日期间在英国四个中心接受阿巴西普治疗的RA患者。从每位患者的索引日期（首次启动生物改善病情抗风湿药的日期）至最近一次就诊、死亡或研究结束（2017年12月31日）的医疗记录中收集数据。
该研究共纳入213例患者。患者接受了多达8线治疗（LOTs）。使用阿巴西普或任何其他生物改善病情抗风湿药治疗6个月和12个月时，DAS28-ESR和DAS28-CRP评分均有所降低。与接受其他生物改善病情抗风湿药相比，接受阿巴西普治疗的患者欧洲抗风湿病联盟（EULAR）反应（良好/中等/无反应）分布更有利（6个月时为22.8%/41.3%/35.9%，而接受其他生物改善病情抗风湿药时为16.6%/41.4%/42.1%；12个月时为27.9%/36.1%/36.1%，而接受其他生物改善病情抗风湿药时为21.2%/34.5%/44.2%）。在第1线治疗（LOT1）接受阿巴西普治疗的患者（n = 68）与接受其他生物改善病情抗风湿药的患者相比，治疗持续时间显著更长（53.4个月对17.4个月；p<0.01）；第2线治疗也观察到类似趋势。在6个月后停药的患者中，与接受阿巴西普治疗的患者相比，接受其他生物改善病情抗风湿药治疗的患者中因感染需要使用抗生素的比例更高。
接受包括阿巴西普在内的生物改善病情抗风湿药治疗的RA患者疾病活动度降低。当作为一线或二线治疗接受阿巴西普治疗时，患者的治疗持续时间明显长于接受其他生物改善病情抗风湿药的患者。
