Predictors of abatacept retention over 2 years in patients with rheumatoid arthritis: results from the real-world ACTION study

Alten, Rieke; Mariette, Xavier; Lorenz, Hanns‐Martin; Nüßlein, H.; Gargiulo, Mauro; Navarro, Federico; Chartier, M.; Heitzmann, Julia; Poncet, Coralie; Rauch, C.; Bars, Manuela Le

doi:10.1007/s10067-019-04449-w

Cited by 26 publications

(27 citation statements)

References 42 publications

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“…In our study, the only factor found to be associated with higher drug persistence was CRP < 10 mg/L at ABA initiation. Contrary to the data from the PAN-ABA and ACTION studies, the number of prior bDMARDS and the serological status were not found to be associated with ABA persistence [5,18,20]. There are differences to be taken into account in interpreting and comparing our results with previous studies.…”

Section: Discussioncontrasting

confidence: 99%

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Actual Persistence of Abatacept in Rheumatoid Arthritis: Results of the French-Ric Network

Salmon

Letarouilly²,

Goëb

et al. 2020

JCM

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Objectives: Data on abatacept (ABA) persistence in routine practice are limited. We aimed to study ABA persistence rates at 12 months, according to the date of initiation, and to analyze the factors associated with persistence at 12 months. Methods: We performed an observational, ambispective, multi-center study from January 2008 to July 2016, based on the French-RIC Network. We defined three groups of patients followed up for rheumatoid arthritis (RA), according to the date of initiation of ABA therapy: Group 1 (from 2007 to 31 July 2010: ABA indicated after anti-TNF failure); Group 2 (from 1 August 2010 to 31 March 2014: ABA indicated after conventional antirheumatic drugs failure); Group 3 (from 1 April 2014 to 1 July 2016: ABA available by the subcutaneous injection). Results: Among 517 patients who initiated ABA, drug persistence at 12 months was 68%. The only factor significantly associated with persistence rate at 12 months was C-reactive protein (CRP) < 10 mg/L at ABA initiation (odds ratio (OR) 0.6, 95% confidence interval 0.3–0.9; p = 0.0016). There was no significant difference in drug persistence according to date of initiation, the line of biological disease-modifying antirheumatic drugs (bDMARD) therapy or the route of administration. Conclusions: In routine practice, over time, ABA has come to be initiated earlier in the course of therapy for RA in France. Abatacept persistence is similar to that reported in the Orencia Rheumatoid Arthritis (ORA) registry, and does not differ according to the date of initiation. The only factor found to be associated with the persistence rate at 12 months was CRP < 10 mg/L at ABA initiation.

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Section: Discussioncontrasting

confidence: 99%

“…Regarding drug persistence, our results at 12 months are comparable to those of the observational ACTION study (n = 2350), which reported pursuance of intravenous ABA in 78% in bDMARDS naïve patients, and in 70% of patients with failed bDMARD therapy [18]. Conversely, drug persistence at 24 months was similar, at 48% [19,20].…”

Section: Discussionsupporting

confidence: 80%

Actual Persistence of Abatacept in Rheumatoid Arthritis: Results of the French-Ric Network

Salmon

Letarouilly²,

Goëb

et al. 2020

JCM

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“…Safety in the ACTION study has been reported previously [7]. Briefly, in the other countries cohort 268 SAEs were reported in 141/1673 (8.4%) patients; 94 of these SAEs led to abatacept discontinuation.…”

Section: Other Countries Cohortmentioning

confidence: 83%

“…AbataCepT In rOutiNe clinical practice (ACTION) was a 2-year, observational, prospective study of patients with moderate-to-severe RA who initiated intravenous abatacept therapy during routine clinical practice [4][5][6][7]. The study was carried out across Europe (Austria, Belgium, Czech Republic, Denmark, France, Germany, Greece, Italy, Netherlands, Spain, and Switzerland) and Canada from May 2008 to December 2013 and included patients who initiated abatacept as a first-, second-, or further-line biologic.…”

Section: Introductionmentioning

confidence: 99%

Abatacept retention and clinical outcomes in rheumatoid arthritis: real-world data from the German cohort of the ACTION study and a comparison with other participating countries

et al. 2019

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Introduction AbataCepT In rOutiNe clinical practice (ACTION; NCT02109666) was an observational study of patients with rheumatoid arthritis who initiated intravenous abatacept in clinical practice. We aimed to compare abatacept retention rates and clinical outcomes in patients from Germany versus other countries. Method Baseline characteristics, crude retention rates, and clinical outcomes were compared by treatment line in the German cohort at 2 years. In addition, biologic-naïve patients were compared with biologic-naïve patients pooled from other participating countries. Results In the German cohort, 677/680 (99.6%) patients enrolled were evaluable and 171/677 (25.3%) were biologic naïve. At baseline, abatacept monotherapy was received by a similar proportion of biologic-naïve and biologic-failure patients in the German cohort, but by a greater proportion of biologic-naïve patients in German versus other countries cohort (27.5 vs. 12.9%). The overall crude abatacept retention rate at 2 years in the German cohort was 39.9%; retention rate did not differ significantly by treatment line, but among biologic-naïve patients it was lower in Germany than in the other countries cohort (42.1 vs. 58.7%; log-rank test p < 0.001). At 2 years, good/moderate European League Against Rheumatism (EULAR) response rates in biologic-naïve patients were 85.5% in the German and 92.1% in other countries cohort (p = 0.163). Conclusions In the German cohort of ACTION, abatacept retention at 2 years was similar in biologic-naïve and biologic-failure patients. Biologic-naïve patients in German cohort had a significantly lower abatacept retention rate and a trend of lower good/ moderate EULAR response rate than those in the other countries cohort. Key Points • Analyses of data from national patient cohorts provide insight on local treatment patterns. • In the German cohort of the ACTION study, abatacept retention at 2 years was similar in biologic-naïve and biologic-failure patients. • Biologic-naïve patients from the German cohort had a significantly lower abatacept retention rate and a trend of lower good/ moderate EULAR response rate than patients from other countries. • Data from large international studies may not be directly applicable to individual countries.

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“…Therefore, long-term efficacy and safety of treatment in a chronic disease such as RA require validation in routine medical practice. The AbataCepT In rOutiNe clinical practice (ACTION; ClinicalTrials.gov identifier: NCT02109666) study provided crucial data on the retention of abatacept and prognostic factors of retention in patients with RA in routine clinical practice across Europe and Canada [17][18][19].…”

Section: Introductionmentioning

confidence: 99%

Up to 5-year retention of abatacept in Belgian patients with moderate-to-severe rheumatoid arthritis: a sub-analysis of the international, observational ACTION study

et al. 2020

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Favorable efficacy and safety profiles have been demonstrated for abatacept in patients with rheumatoid arthritis (RA) in randomized controlled trials, but these data require validation during long-term follow-ups in routine clinical practice. This study explored long-term safety and retention rates in RA patients treated with intravenous abatacept in the Belgian cohort of the international AbataCepT In rOutiNe clinical practice (ACTION) study (NCT02109666). This non-interventional, observational, longitudinal study included Belgian patients aged ≥ 18 years with moderate-to-severe RA who started intravenous abatacept treatment as first- or second/further-line biologic therapy in routine clinical practice. Between October 2010 and December 2012, 141 patients were enrolled in this cohort, of whom 135 evaluable patients (6 biologic-naïve; 129 previously exposed to ≥ 1 prior biologic disease modifying anti-rheumatic drugs) were eligible for the descriptive analysis; 131/135 were included in the effectiveness analysis. Mean disease duration was 10.5 years (standard deviation 9.7) before abatacept initiation. RA patients presented with high disease activity and comorbidity rate, having failed multiple previous treatment options. In this cohort, the 5-year abatacept retention rate was 34% (95% confidence interval, 23−45%) per protocol, and 51% (95% confidence interval, 40−61%) when temporary discontinuations of abatacept > 84 days ( n = 24) were not considered as treatment discontinuations. After 5 years of abatacept treatment, clinical outcomes were favorable [good/moderate European League Against Rheumatism (EULAR) responses in 91.7% patients]. No new safety signals were detected for abatacept in routine clinical practice. In this difficult-to-treat Belgian RA population, high retention rates, good clinical outcomes and favorable safety profile were observed with abatacept. Electronic supplementary material The online version of this article (10.1007/s00296-020-04619-z) contains supplementary material, which is available to authorized users.

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Predictors of abatacept retention over 2 years in patients with rheumatoid arthritis: results from the real-world ACTION study

Cited by 26 publications

References 42 publications

Actual Persistence of Abatacept in Rheumatoid Arthritis: Results of the French-Ric Network

Actual Persistence of Abatacept in Rheumatoid Arthritis: Results of the French-Ric Network

Abatacept retention and clinical outcomes in rheumatoid arthritis: real-world data from the German cohort of the ACTION study and a comparison with other participating countries

Up to 5-year retention of abatacept in Belgian patients with moderate-to-severe rheumatoid arthritis: a sub-analysis of the international, observational ACTION study

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