title: Efficacy of abatacept and tocilizumab in patients with rheumatoid arthritis treated in clinical practice: results from the nationwide Danish DANBIO registry.
abstract: OBJECTIVE
  To describe drug survival, disease activity and clinical response in patients with rheumatoid arthritis (RA) treated with abatacept or tocilizumab in routine care, based on prospectively registered observational data from the nationwide Danish DANBIO registry.
  
  
  METHODS
  150 Patients with RA treated with abatacept and 178 treated with tocilizumab were identified. Drug survival was investigated. Response data were available in 104 and 97 patients, respectively. Changes in 28-joint Disease Activity Score (DAS28) based on C-reactive protein (CRP) and European League Against Rheumatism (EULAR) response after 24 and 48 weeks were investigated. No direct comparison of drugs was made.
  
  
  RESULTS
  Median (IQR) disease duration was 8.5 (3-14)/9 (3-12) years (abatacept/tocilizumab). 95%/93% of patients had previously received one or more tumour necrosis factor inhibitor (TNFi). After 48 weeks, 54%/64% of patients (abatacept/tocilizumab) maintained treatment. Among patients with available response data, DAS28 was 5.3 (4.7-6.1), 3.4 (2.7-4.9) and 3.3 (2.5-4.3) at baseline, weeks 24 and 48, respectively, in the abatacept group and 5.4 (4.7-6.2), 2.9 (2.3-4.0) and 2.5 (1.9-4.5) in the tocilizumab group. At weeks 24 and 48, the remission rates for abatacept/tocilizumab were 19%/39% and 26%/58%, respectively. EULAR good-or-moderate response rates were 70%/88% and 77%/84%, respectively. The decline in DAS28 variables over time appeared similar between drugs, except for CRP, which seemed to decline more rapidly among tocilizumab-treated patients.
  
  
  CONCLUSIONS
  In patients with RA (≥90% TNFi failures), a good-or-moderate EULAR response was achieved in ≥70% of patients treated with abatacept or tocilizumab for 24 weeks in routine care. Apparent declines in DAS28 variables over time were similar between drugs, except for the more rapid CRP decline among tocilizumab-treated patients, directly caused by interleukin 6 inhibition.
authors.affiliation: Department of Rheumatology, Copenhagen University Hospital Glostrup, Glostrup, Denmark. hsk967@alumni.ku.dk
authors.forename: Henrik Christian
authors.initials: HC
authors.lastname: Leffers
authors.forename: Mikkel
authors.initials: M
authors.lastname: Ostergaard
authors.forename: Bente
authors.initials: B
authors.lastname: Glintborg
authors.forename: Niels Steen
authors.initials: NS
authors.lastname: Krogh
authors.forename: Heidi
authors.initials: H
authors.lastname: Foged
authors.forename: Ulrik
authors.initials: U
authors.lastname: Tarp
authors.forename: Tove
authors.initials: T
authors.lastname: Lorenzen
authors.forename: Annette
authors.initials: A
authors.lastname: Hansen
authors.forename: Michael Sejer
authors.initials: MS
authors.lastname: Hansen
authors.forename: Martin Skov
authors.initials: MS
authors.lastname: Jacobsen
authors.forename: Lene
authors.initials: L
authors.lastname: Dreyer
authors.forename: Merete Lund
authors.initials: ML
authors.lastname: Hetland
mesh_terms: D000069594:Abatacept; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000188:drug therapy*; D002097:C-Reactive Protein / Q000378:metabolism; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D018796:Immunoconjugates / Q000627:therapeutic use*; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors; D055815:Young Adult
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents; D018796:Immunoconjugates; D014409:Tumor Necrosis Factor-alpha; D000069594:Abatacept; D002097:C-Reactive Protein; C502936:tocilizumab