title: Abatacept monotherapy compared with abatacept plus disease-modifying anti-rheumatic drugs in rheumatoid arthritis patients: data from the ORA registry.
abstract: BACKGROUND
  Retention rate, efficacy, and safety of abatacept (ABA) was compared between patients with rheumatoid arthritis receiving ABA as monotherapy to those in combination ABA + conventional synthetic DMARD (csDMARD).
  
  
  METHODS
  The patients were obtained from the ORA registry. The retention rate was analysed in two ways: (1) therapeutic strategy retention, in which the addition of a csDMARD was considered to indicate failure of the monotherapy strategy; and (2) ABA retention, which was assessed by the discontinuation of ABA regardless of other treatment modifications. Efficacy and safety were compared between ABA initiated alone and ABA used in combination with a csDMARD.
  
  
  RESULTS
  The retention rate at month 6 (M6) was evaluated in 569 patients. A significant difference was identified in the retention rate between the ABA monotherapy strategy and the ABA + csDMARD strategy (58.5 % [110/188] vs. 68 % [258/381], respectively, p = 0.031). No significant difference was identified in the ABA retention rate initiated either as a monotherapy or in combination with csDMARDs (75 % [142/188] vs. 76 % [291/381], respectively, p = 0.824). Data regarding ABA efficacy were available for 444 patients. There was no significant difference in the responder proportion after 6 months of treatment between ABA monotherapy and ABA + csDMARD treatment (60.2 % [88/146] vs. 60 % [179/298], respectively, p = 0.967).
  
  
  CONCLUSIONS
  This "real-life" analysis, which is relevant for bedside practice, emphasised the satisfactory efficacy and safety of ABA used in monotherapy, which provides an acceptable alternative when csDMARDs are undesirable.
authors.affiliation: Département de Rhumatologie, Hôpital Pellegrin, CHU de Bordeaux, Place Amélie Raba-Léon, 33076, Bordeaux, France. me.truchetet@gmail.com.|Groupe Epidemiologie Clinique des Maladies Inflammatoires d'Aquitaine (GECMIA) Study Group, CHU de Bordeaux, Place Amélie Raba-Léon, 33076, Bordeaux, France. me.truchetet@gmail.com.
authors.forename: Marie-Elise
authors.initials: ME
authors.lastname: Truchetet
authors.affiliation: Département de Rhumatologie, Hôpital Pellegrin, CHU de Bordeaux, Place Amélie Raba-Léon, 33076, Bordeaux, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Poursac
authors.affiliation: Département de Rhumatologie, Hôpital Pellegrin, CHU de Bordeaux, Place Amélie Raba-Léon, 33076, Bordeaux, France.
authors.forename: Thomas
authors.initials: T
authors.lastname: Barnetche
authors.affiliation: Département de Rhumatologie, Hôpital de Dax, 18 Avenue Paul Doumer, 40100, Dax, France.
authors.forename: Emilie
authors.initials: E
authors.lastname: Shipley
authors.affiliation: Hôpitaux Universitaires de Strasbourg et Universités de Strasbourg, 1 Place de L Hôpital, 67000, Strasbourg, France.
authors.forename: Jacques-Eric
authors.initials: JE
authors.lastname: Gottenberg
authors.affiliation: Département de Rhumatologie, Hôpital Pellegrin, CHU de Bordeaux, Place Amélie Raba-Léon, 33076, Bordeaux, France.
authors.forename: Bernard
authors.initials: B
authors.lastname: Bannwarth
authors.affiliation: Département de Rhumatologie, Hôpital Pellegrin, CHU de Bordeaux, Place Amélie Raba-Léon, 33076, Bordeaux, France.|Groupe Epidemiologie Clinique des Maladies Inflammatoires d'Aquitaine (GECMIA) Study Group, CHU de Bordeaux, Place Amélie Raba-Léon, 33076, Bordeaux, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Richez
authors.affiliation: Département de Rhumatologie, Hôpital Pellegrin, CHU de Bordeaux, Place Amélie Raba-Léon, 33076, Bordeaux, France.|Groupe Epidemiologie Clinique des Maladies Inflammatoires d'Aquitaine (GECMIA) Study Group, CHU de Bordeaux, Place Amélie Raba-Léon, 33076, Bordeaux, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: Schaeverbeke
mesh_terms: D000069594:Abatacept / Q000008:administration & dosage; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012042:Registries; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D018501:Antirheumatic Agents; D000069594:Abatacept
keywords: Abatacept; Biologic agent; Monotherapy; Retention rate; Rheumatoid arthritis