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AB0543 Remission using different composite disease indices in MTX-IR RA patients treated with abatacept or infliximab, +MTX
  1. J. Smolen1,
  2. M. Dougados2,
  3. C. Gaillez3,
  4. C. Poncet4,
  5. M. Le Bars3,
  6. A. Elegbe5,
  7. M. Schiff6
  1. 1Medical University of Vienna and Hietzing Hospital, Vienna, Austria
  2. 2Hôpital Cochin, Paris
  3. 3Bristol-Myers Squibb, Rueil-Malmaison
  4. 4Docs International, Sèvres, France
  5. 5Bristol-Myers Squibb, Princeton
  6. 6University of Colorado, Denver, United States

Abstract

Background Levels of acute-phase reactants, which correlate with clinical disease activity in RA,1 are differentially weighted in the calculation of disease activity indices such as DAS28/SDAI. Acute-phase reactants and disease activity measures may be affected differently by biologics with different mechanisms of action.2

Objectives To evaluate remission using the ACR/EULAR index-based definition of remission3 vs DAS28-defined remission in biologic-naïve MTX-IR RA patients (pts) from AIM4 and ATTEST5 trials, and assess the contribution of core components.

Methods In AIM, pts were randomized to abatacept (ABA; ∼10 mg/kg every 4 wks) or PBO, plus MTX.4 In ATTEST, pts were randomized to ABA (∼10 mg/kg every 4 wks), IFX (3 mg/kg every 8 wks), or PBO (every 4 wks), plus MTX.5 Post-hoc analyses evaluated remission according to DAS28(CRP) and SDAI at 6 mths; missing data were imputed by LOCF.

Results Baseline demographics and disease characteristics were similar between groups in each trial.4,5 All pts achieving DAS28 remission at 6 mths were either in SDAI remission or SDAI LDAS. At 6 mths, for pts achieving SDAI remission, core components were generally similar and≤1.

Conclusions In ATTEST, remission rates at 6 mths were similar for abatacept and IFX independent of the composite measure. When using SDAI remission criteria to assess remission, core components of abatacept-treated pts were consistent in AIM and ATTEST and similar to that of IFX-treated pts and ≤1, suggesting no residual disease activity in contrast with DAS28 remission criteria. This confirms that SDAI is a more accurate composite index than DAS28-CRP in assessing true remission.

  1. Mallya RK et al. J Rheumatol 1982;9:224–8;

  2. Smolen JS, Aletaha D. Arthritis Rheum 2011;63:43–52;

  3. Felson DT et al. Ann Rheum Dis 2011;70:404–13.

  4. Kremer JM et al. Ann Int Med 2006;144:865–76;

  5. Schiff M et al. Ann Rheum Dis 2008;67:1096–103.

Disclosure of Interest J. Smolen Grant/Research support from: Abbott Laboratories, Bristol-Myers Squibb, Hoffmann-La Roche, Inc., Schering-Plough, UCB, Inc., Pfizer, Consultant for: Abbott Laboratories, Amgen Inc., AstraZeneca, Bristol-Myers Squibb, Centocor, Inc., Eli Lilly and Company, Merck, Novo Nordisk, Roche, sanofi-aventis, UCB, Inc., M. Dougados Grant/Research support from: Bristol-Myers Squibb, Consultant for: Bristol-Myers Squibb, Speakers Bureau: Bristol-Myers Squibb, C. Gaillez Shareholder of: Bristol-Myers Squibb, Employee of: Bristol-Myers Squibb, C. Poncet: None Declared, M. Le Bars Shareholder of: Bristol-Myers Squibb, Employee of: Bristol-Myers Squibb, A. Elegbe Shareholder of: Bristol-Myers Squibb, Employee of: Bristol-Myers Squibb, M. Schiff Consultant for: Bristol-Myers Squibb

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