Clinical, radiographic and functional efficacy of abatacept in routine care for rheumatoid arthritis patients: Abatacept Leading Trial for RA on Imaging Remission (ALTAIR) study.
OBJECTIVE
To investigate the efficacy and safety of abatacept for treating patients with rheumatoid arthritis (RA) in routine clinical practice and to determine the prognostic factors affecting clinical outcomes.


METHODS
We performed a retrospective study of 194 RA patients treated with abatacept. Clinical outcomes at 1 year after the treatment were assessed. Joint damage was assessed by the van der Heijde-modified total Sharp score (mTSS).


RESULTS
Of the 194 patients, abatacept was discontinued in 51 patients, resulting in a retention rate at week 52 of 73.7%. At week 52, 23.7% of patients achieved clinical remission (SDAI ≤3.3). Lower SDAI and higher RF titre at baseline were the prognostic factor for SDAI at 52 weeks. Structural remission (ΔmTSS ≤0.5) was achieved in 73.4% of patients. However, clinical relevant radiographic progression which was defined as an increase in ΔmTSS >3 in a year, occurred in 7.6% of patients. Likewise, rapid radiological progression, which was defined as an increase in ΔmTSS >5 in a year, was observed in 6.4% of patients. 16.5% of patients achieved comprehensive disease remission, which was defined as SDAI ≤3.3, HAQ-DI ≤0.5, ΔmTSS ≤0.5, while 22.4% of patients achieved comprehensive disease control (CDC), which was defined as SDAI ≤11.0, HAQ-DI ≤0.5, ΔmTSS ≤0.5.


CONCLUSIONS
The present results confirm that abatacept is effective and safe in routine clinical practice. It is possible that abatacept is more effective in seropositive RA patients with significant immunological abnormality.
The First Department of Internal Medicine, University of Occupational and Environmental Health, Fukuoka, Japan.
Satoshi
S
Kubo
The First Department of Internal Medicine, University of Occupational and Environmental Health, Fukuoka, Japan.
Kazuhisa
K
Nakano
The First Department of Internal Medicine, University of Occupational and Environmental Health, Fukuoka, Japan.
Shingo
S
Nakayamada
The First Department of Internal Medicine, University of Occupational and Environmental Health, Fukuoka, Japan.
Shintaro
S
Hirata
The First Department of Internal Medicine, University of Occupational and Environmental Health, Fukuoka, Japan.
Shunsuke
S
Fukuyo
The First Department of Internal Medicine, University of Occupational and Environmental Health, Fukuoka, Japan.
Norifumi
N
Sawamukai
The First Department of Internal Medicine, University of Occupational and Environmental Health, Fukuoka, Japan.
Kazuyoshi
K
Saito
The First Department of Internal Medicine, University of Occupational and Environmental Health, Fukuoka, Japan. tanaka@med.uoeh-u.ac.jp.
Yoshiya
Y
Tanaka
D000069594:Abatacept / Q000009:adverse effects / Q000627:therapeutic use*; D000368:Aged; D018501:Antirheumatic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000276:immunology / Q000503:physiopathology; D001175:Arthrography; D015415:Biomarkers / Q000097:blood; D018450:Disease Progression; D005260:Female; D006304:Health Status; D006305:Health Status Indicators; D006801:Humans; D007564:Japan; D007596:Joints / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000276:immunology / Q000503:physiopathology; D053208:Kaplan-Meier Estimate; D008213:Lymphocyte Activation / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011237:Predictive Value of Tests; D012074:Remission Induction; D012189:Retrospective Studies; D012698:Serologic Tests; D013601:T-Lymphocytes / Q000187:drug effects / Q000276:immunology; D013997:Time Factors; D016896:Treatment Outcome
D018501:Antirheumatic Agents; D015415:Biomarkers; D000069594:Abatacept