Department of Rheumatology, Kita-Harima Medical Center, Hyogo, Japan.
Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine, Tokyo, Japan.
Mod Rheumatol. 2024 Feb 26;34(2):297-306. doi: 10.1093/mr/road045.
The aim of the article is to investigate the associations of disease duration and anti-cyclic citrullinated peptide antibody (ACPA) status with the effectiveness of abatacept in biologic-naïve patients with rheumatoid arthritis (RA).
We performed post hoc analyses of the Orencia® Registry in Geographically Assembled Multicenter Investigation (ORIGAMI) study of biologic-naïve RA patients aged ≥20 years with moderate disease activity who were prescribed abatacept. Changes in the Simplified Disease Activity Index (SDAI) and Japanese Health Assessment Questionnaire (J-HAQ) at 4, 24, and 52 weeks of treatment were analysed in patients divided according to ACPA serostatus (positive/negative), disease duration (<1/≥1 year), or both.
SDAI scores decreased from baseline in all groups. SDAI scores tended to decrease more in the ACPA-positive group and disease duration <1-year group than in the ACPA-negative group and disease duration ≥1-year group, respectively. In the disease duration <1-year group, SDAI tended to decrease more in the ACPA-positive group than in the ACPA-negative group. Disease duration was independently associated with the change in SDAI and SDAI remission at Week 52 in multivariable regression models.
These results suggest that starting abatacept within 1 year of diagnosis was associated with greater effectiveness of abatacept in biologic-naïve patients with RA and moderate disease activity.
本文旨在探讨疾病持续时间和抗环瓜氨酸肽抗体(ACPA)状态与生物初治类风湿关节炎(RA)患者接受阿巴西普疗效的相关性。
我们对生物初治 RA 患者的 ORIGAMI 研究中的 ORIGAMI 登记处进行了事后分析,这些患者年龄≥20 岁,疾病活动度中度,接受了阿巴西普治疗。根据 ACPA 血清学状态(阳性/阴性)、疾病持续时间(<1/≥1 年)或两者的不同,分析了治疗第 4、24 和 52 周时简化疾病活动指数(SDAI)和日本健康评估问卷(J-HAQ)的变化。
所有组的 SDAI 评分均从基线下降。与 ACPA 阴性组和疾病持续时间≥1 年组相比,ACPA 阳性组和疾病持续时间<1 年组的 SDAI 评分下降趋势更明显。在疾病持续时间<1 年的组中,ACPA 阳性组的 SDAI 评分下降趋势更为明显。在多变量回归模型中,疾病持续时间与 SDAI 的变化和第 52 周时 SDAI 缓解相关。
这些结果表明,在诊断后 1 年内开始使用阿巴西普与生物初治 RA 且疾病活动度中度的患者中阿巴西普的疗效更好相关。