Rheumatology Department, Hôpital Salengro, Centre Hospitalier Universitaire Lille, Université de Lille, France.
Rheumatology Department, Hôpital Pierre-Paul Riquet, Centre Hospitalier Universitaire Toulouse, France.
Clin Exp Rheumatol. 2024 Jul;42(7):1377-1386. doi: 10.55563/clinexprheumatol/ddx0fz. Epub 2024 Mar 3.
While multiple studies have investigated treatment persistence rates with intravenous abatacept, limited information is available about real-world treatment continuation with the subcutaneous form. The international ASCORE study described the characteristics and treatment persistence of real-world patients with rheumatoid arthritis (RA) receiving subcutaneous abatacept. This article presents the findings of the French cohort.
This was an observational study in French RA patients who initiated subcutaneous abatacept between August 2014 and January 2017. The primary endpoint was treatment maintenance at 2 years, analysed according to the number of previous biologic therapies.
Of 546 evaluable patients, 281 (51.5%) were biologic-naive, 265 (48.5%) had experienced failure with 1 (n=134; 24.5%) or ≥2 (n=131; 24.0%) biologic therapies. At enrolment, patients who had experienced failure with ≥1 biologic therapy had more erosions and a longer duration of RA compared with biologic-naive patients, but had comparable mean disease activity scores. Overall, 43.0% of patients (95% confidence interval 38.6-47.2) were still taking subcutaneous abatacept at 2 years, which was comparable with that in other countries participating in ASCORE. The abatacept persistence rate was higher in biologic-naive patients (48.8%) than in those with 1 (40.9%) or ≥2 (32.8%) biologic therapy failures. The main reason for discontinuing abatacept was lack of efficacy (46.6%).
In current practice in France, the rate of subcutaneous abatacept persistence at 2 years was comparable with that of the intravenous form. Treatment persistence was higher when abatacept was used as first-line versus later-line biologic therapy.
虽然多项研究调查了静脉用阿巴西普的治疗持续率，但关于皮下用阿巴西普的实际治疗持续情况的信息有限。国际 ASCORE 研究描述了接受皮下用阿巴西普的类风湿关节炎（RA）真实世界患者的特征和治疗持续性。本文介绍了法国队列的研究结果。
这是一项在法国 RA 患者中进行的观察性研究，这些患者在 2014 年 8 月至 2017 年 1 月期间开始接受皮下用阿巴西普治疗。主要终点是 2 年时的治疗维持，根据之前使用的生物治疗药物数量进行分析。
在 546 例可评估患者中，281 例（51.5%）为生物治疗初治患者，265 例（48.5%）曾使用过 1 种（n=134；24.5%）或≥2 种（n=131；24.0%）生物治疗药物。在入组时，与生物治疗初治患者相比，曾使用过≥1 种生物治疗药物的患者有更多的侵蚀和更长的 RA 病程，但疾病活动评分相似。总体而言，43.0%的患者（95%置信区间 38.6-47.2）在 2 年时仍在接受皮下用阿巴西普治疗，与参与 ASCORE 的其他国家相当。生物治疗初治患者的阿巴西普持续率（48.8%）高于仅使用 1 种（40.9%）或≥2 种（32.8%）生物治疗失败的患者。停止使用阿巴西普的主要原因是疗效不佳（46.6%）。
在法国当前的实践中，2 年时皮下用阿巴西普的持续率与静脉用阿巴西普相当。当阿巴西普作为一线而非后续生物治疗药物使用时，治疗持续率更高。
