title: Body mass does not impact the clinical response to intravenous abatacept in patients with rheumatoid arthritis. Analysis from the "pan-European registry collaboration for abatacept (PANABA).
abstract: Some evidences suggest that obesity impairs the effectiveness of TNF inhibitors. We examined the impact of body mass index (BMI) on the clinical effectiveness of abatacept in rheumatoid arthritis (RA) patients. This is a pooled analysis of 10 prospective cohorts of RA patients. All patients with available BMI were included in this study. The primary endpoint was drug retention of abatacept in the different BMI categories. Multivariable Cox regression was used to estimate hazard ratios (HRs) for drug discontinuation. A secondary endpoint was EULAR/LUNDEX response rates at 6/12 months. Of the 2015 RA patients initiating therapy with IV abatacept, 380 (18.9%) were classified as obese. Obese patients had more functional disability, and were less often RF positive. The median abatacept retention time was 1.91 years for obese RA patients compared to 2.12 years for non-obese patients (p = 0.15). The risk of abatacept discontinuation was not significantly different for overweight (HR 1.03 (95% CI 0.89-1.19)), or for obese (HR 1.08 (95% CI 0.89-1.30)) compared to normal-weight patients. Rheumatoid factor positivity reduced the risk of abatacept discontinuation (HR 0.83 (95% CI 0.72-0.95)), while previous biologic therapy was positively associated with drug interruption (HRs increasing from 1.68 to 2.16 with the line of treatments). Obese and non-obese patients attained similar rates of EULAR/LUNDEX clinical response at 6/12 months. Drug retention and clinical response rates to abatacept do not seem to be decreased by obesity in RA patients.
authors.affiliation: Department of Emergency and Organ Trasplantation-Rheumatology Unit, University of Bari, Policlinico, Piazza G. Cesare 11, 70124, Bari, Italy. florenzo.iannone@uniba.it.
authors.forename: Florenzo
authors.initials: F
authors.lastname: Iannone
authors.affiliation: University Hospital, Geneva, Switzerland.
authors.forename: Delphine S
authors.initials: DS
authors.lastname: Courvoisier
authors.affiliation: University Hospital, Strasbourg, France.
authors.forename: Jacques Eric
authors.initials: JE
authors.lastname: Gottenberg
authors.affiliation: Rheumatology Department Hospital Clínic of Barcelona, Barcelona, Spain.
authors.forename: Maria Victoria
authors.initials: MV
authors.lastname: Hernandez
authors.affiliation: Diakonhjemmet Hospital, Oslo, Norway.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Lie
authors.affiliation: Reuma.pt, Santa Maria Hospital, Lisbon, Portugal.
authors.forename: Helena
authors.initials: H
authors.lastname: Canhão
authors.affiliation: University Hospital, Prague, Czech Republic.
authors.forename: Karel
authors.initials: K
authors.lastname: Pavelka
authors.affiliation: DANBIO and COPECARE, Center for Rheumatology and Spine Diseases, Glostrup Hospital, Glostrup, Denmark.|Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Merete Lund
authors.initials: ML
authors.lastname: Hetland
authors.affiliation: Lund University, Malmö, Sweden.|Skåne University Hospital, Malmö, Sweden.
authors.forename: Carl
authors.initials: C
authors.lastname: Turesson
authors.affiliation: Assistance Publique - Hôpitaux de Paris, Hôpitaux Universitaires Paris-Sud, INSERM U1012, Université Paris-Sud, Le Kremlin Bicêtre, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Mariette
authors.affiliation: Institut of Rheumatology of Montreal, CHUM, Montreal, Canada.
authors.forename: Denis
authors.initials: D
authors.lastname: Choquette
authors.affiliation: University Hospital, Geneva, Switzerland.
authors.forename: Axel
authors.initials: A
authors.lastname: Finckh
mesh_terms: D000069594:Abatacept / Q000008:administration & dosage* / Q000009:adverse effects; D000328:Adult; D000368:Aged; D018501:Antirheumatic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D015992:Body Mass Index; D005060:Europe; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012042:Registries; D012074:Remission Induction; D012217:Rheumatoid Factor / Q000097:blood; D016896:Treatment Outcome
chemical_list: D018501:Antirheumatic Agents; D000069594:Abatacept; D012217:Rheumatoid Factor
keywords: Abatacept; Body mass index; Drug survival; Rheumatoid arthritis