title: Decreased use of glucocorticoids in biological-experienced patients with rheumatoid arthritis who initiated intravenous abatacept: results from the 2-year ACTION study.
abstract: BACKGROUND
  Prolonged glucocorticoid use may increase the risk of adverse safety outcomes, including cardiovascular events. The European League Against Rheumatism and the Canadian Rheumatology Association advise tapering glucocorticoid dose as rapidly as clinically feasible. There is a paucity of published data on RA that adequately describe concomitant treatment patterns.
  
  
  METHODS
  ACTION (AbataCepT In rOutiNe clinical practice) is a non-interventional cohort study of patients from Europe and Canada that investigated the long-term retention of intravenous abatacept in clinical practice. We assessed concomitant glucocorticoids in patients with established RA who had participated in ACTION and received ≥1 biological agent prior to abatacept initiation.
  
  
  RESULTS
  The analysis included 1009 patients. Glucocorticoids were prescribed at abatacept initiation in 734 (72.7%) patients at a median 7.5 mg/day dose (n=692). Of the patients who remained on abatacept at 24 months, 40.7% were able to decrease their dose of glucocorticoids, including 26.9% who decreased their dose from >5 mg/day to ≤5 mg/day.
  
  
  CONCLUSIONS
  Reduction and/or cessation of glucocorticoid therapy is possible with intravenous abatacept in clinical practice.
authors.affiliation: Department of Rheumatology , Schlosspark-Klinik, University Medicine , Berlin , Germany.
authors.forename: Rieke
authors.initials: R
authors.lastname: Alten
authors.affiliation: Department of Clinical Immunology and Rheumatology , University of Erlangen-Nuremberg , Nuremberg , Germany.
authors.forename: Hubert
authors.initials: H
authors.lastname: Nüßlein
authors.affiliation: Department of Rheumatology , University of Siena , Siena , Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Galeazzi
authors.affiliation: Department of Rheumatology , University Hospital , Heidelberg , Germany.
authors.forename: Hanns-Martin
authors.initials: HM
authors.lastname: Lorenz
authors.affiliation: Department of Rheumatology , VU University Medical Center/Jan van Breemen Research Institute , Amsterdam , The Netherlands.
authors.forename: Michael T
authors.initials: MT
authors.lastname: Nurmohamed
authors.affiliation: Department of Rheumatology , St Joseph's Hospital and McMaster University , Hamilton, Ontario , Canada.
authors.forename: William G
authors.initials: WG
authors.lastname: Bensen
authors.affiliation: Department of Rheumatology and Immunology , Charité-Universitätsmedizin , Berlin , Germany.
authors.forename: Gerd R
authors.initials: GR
authors.lastname: Burmester
authors.affiliation: Center for Chronic Immunodeficiency, University Medical Center , Freiburg , Germany.
authors.forename: Hans-Hartmut
authors.initials: HH
authors.lastname: Peter
authors.affiliation: Institute of Rheumatology and Clinic of Rheumatology, Charles University , Prague , Czech Republic.
authors.forename: Karel
authors.initials: K
authors.lastname: Pavelka
authors.affiliation: Department of Real-World Research , Chiltern International , Neuilly , France.
authors.forename: Mélanie
authors.initials: M
authors.lastname: Chartier
authors.affiliation: Department of Biostatistics , DOCS International , Nanterre , France.
authors.forename: Coralie
authors.initials: C
authors.lastname: Poncet
authors.affiliation: Department of Medical Immunoscience , Bristol-Myers Squibb , Munich , Germany.
authors.forename: Christiane
authors.initials: C
authors.lastname: Rauch
authors.affiliation: Excelya , Boulogne-Billancourt , France.
authors.forename: Yedid
authors.initials: Y
authors.lastname: Elbez
authors.affiliation: Department of Medical Affairs , Bristol-Myers Squibb , Rueil-Malmaison , France.
authors.forename: Manuela
authors.initials: M
authors.lastname: Le Bars
keywords: Corticosteroids; DMARDs (biologic); Rheumatoid Arthritis