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SAT0140 Effectiveness of Abatacept Against Rheumatoid Arthritis in Daily Clinical Practice - Orbit Study
  1. T. Takeuchi1,
  2. Y. Tanaka2,
  3. K. Amano3,
  4. J. Kikuchi1,
  5. E. Tanaka4,
  6. S. Hirata2,
  7. H. Nagasawa3,
  8. H. Yasuoka1,
  9. H. Yamanaka4
  1. 1Division of Rheumatology, Department of Internal Medicine, School of Medicine, Keio University, Tokyo
  2. 2The First Department of Internal Medicine, School of Medicine, University of Occupational And Environmental Health Hospital, Kitakyushu
  3. 3Division of Rheumatology and Clinical Immunology, Department of Internal Medicine, Saitama Medical Center, Saitama Medical University, Saitama
  4. 4Institute of Rheumatology, Tokyo Women’s Medical University, Tokyo, Japan

Abstract

Background While abatacept (ABA), launched in 2010, has been used to treat more than 8,000 rheumatoid arthritis (RA) patients in Japan, factors affecting clinical, functional, and structural remission remain unclear.

Objectives To identify the baseline clinical parameters associated with ABA effectiveness.

Methods Orencia® as Biological Intensive Treatment for RA (ORBIT) is a retrospective study conducted in four rheumatology institutes. A total of 141 patients were intravenously administered ABA 10 mg/kg every 4 weeks. Disease activity, disability, and structural damage were assessed using DAS28-ESR and SDAI, HAQ-DI, and modified total Sharp score (mTSS), respectively. Last observation carried forward method and linear extrapolation were used for missing clinical and radiographic data.

Results Baseline characteristics of the 141 analyzed patients were as follows: mean age, 60.8±13.5 years; mean disease duration, 10.2±9.2 years; concomitant use of methotrexate (MTX), 74.5%; MTX dose, 8.0±2.8 mg/week; concomitant use of predonisolone (PSL), 40.4%; PSL dose, 5.2±3.4 mg/day; prior treatment with biologic agents, 51.8%; DAS28-ESR, 5.2±1.4; SDAI, 24.8±12.5; HAQ-DI, 1.4±0.8; and mTSS, 59.4. At week 24 and 52, 80.1% and 67.4% continued ABA treatment, respectively. The main reason for discontinuation was lack of efficacy (28/46 60.9%). The clinical remission defined by DAS28-ESR<2.6 and SDAI≤3.3 were 15.7% and 15.6% at week 24, and 28.6% and 21.3% at week 52, respectively. A total of 36.0% of patients achieved functional remission (HAQ-DI≤0.5). X-ray data were available for assessment in 83.0% of patients, and 54.7% of patients showed ΔmTSS≤0.5. Results of univariate logistic regression showed factors affecting SDAI remission and functional remission at week 52 to be disease duration (p=0.005 and p=0.014), mTSS at week 0 (p=0.0002 and p=0.0007), HAQ-DI score at week 0 (both p<0.0001), prior treatment with biologic agents (p=0.002 and p=0.003). We noted no factors affecting structural remission at week 52.

Conclusions ABA has demonstrated clinical, functional, and structural effectiveness. No prior treatment with biologic agents is likely to lead clinical and functional remission.

Disclosure of Interest T. Takeuchi Grant/research support from: Abott Japan Co., LTD., Astellas Pharma, Bristol-Myers K.K., Chugai Pharmaceutical Co., LTD., Daiichi Sankyo Co., LTD., Eisai Co., LTD., Janssen Pharmaceutical K.K., Mitsubishi Tanabe Pharma Co., Nippon Shinyaku Co., LTD., Otsuka Pharmaceutical, Pfizer Japan Inc., Sanofi-aventis K.K., Santen Pharmaceutical, Takeda Pharmaceutical Co., LTD., Teijin Phrma Ltd., Consultant for: Astra Zeneca, K.K., Eli-Lilly Japan K.K., Novartis Pharma K.K., Mitsubishi Tanabe Pharma Co., Asahi Kasei Medical K.K., Speakers bureau: Abott Japan Co., LTD., Bristol-Myers K.K., Chugai Pharmaceutical Co., LTD., Eisai Co., LTD., Janssen Pharmaceutical K.K., Mitsubishi Tanabe Pharma Co., Pfizer Japan Inc., Takeda Pharmaceutical Co., LTD., Y. Tanaka Grant/research support from: Bristol-Myers Squibb, MSD K.K., Chugai Pharma Co., Ltd., Mitsubishi-Tanabe Pharma Co., Ltd., Astellas Pharma Inc., Abbott Japan Co., Ltd., Eisai Co., Ltd. and Janssen Pharmaceutical K.K., Consultant for: Mitsubishi-Tanabe Pharma Co., Ltd., Abbott Japan Co., Ltd., Eisai Co., Ltd., Chugai Pharma Co., Ltd., Janssen Pharma K.K., Santen Pharma Co., Ltd., Pfizer Japan Inc., Astellas Pharma Inc., Daiichi-Sankyo Co., Ltd., GlaxoSmithKlineK.K., Astra-Zeneca, Otsuka Pharma Co., Ltd., Actelion Pharma Japan Ltd., Eli Lilly Japan K.K., Nippon Kayaku Co., Ltd., UCB Japan Co., Ltd., Quintiles Transnational Japan Co. Ltd., Ono Pharma Co., Ltd., and Novartis Pharma K.K, Speakers bureau: Mitsubishi-Tanabe Pharma Co., Ltd., Abbott Japan Co., Ltd., Eisai Co., Ltd., Chugai Pharma Co., Ltd., Janssen Pharma K.K., Santen Pharma Co., Ltd., Pfizer Japan Inc., Astellas Pharma Inc., Daiichi-Sankyo Co., Ltd., GlaxoSmithKlineK.K., Astra-Zeneca, Otsuka Pharma Co., Ltd., Actelion Pharma Japan Ltd., Eli Lilly Japan K.K., Nippon Kayaku Co., Ltd., UCB Japan Co., Ltd., Quintiles Transnational Japan Co. Ltd., Ono Pharma Co., Ltd., and Novartis Pharma K.K, K. Amano Consultant for: Bristol -Myers Squibb co., J. Kikuchi Consultant for: Pfizer Japan Inc., E. Tanaka: None Declared, S. Hirata: None Declared, H. Nagasawa: None Declared, H. Yasuoka: None Declared, H. Yamanaka Grant/research support from: Abbott, Astellas, Bristol-Myers Squibb, Chugai, Eisai, Janssen, Mitsubishi-Tanabe, Pfizer, Takeda, UCB, Consultant for: Abbott, Astellas, Bristol-Myers Squibb, Chugai, Eisai, Janssen, Mitsubishi-Tanabe, Pfizer, Takeda, UCB, Consultant for: Abbott, Astellas, Bristol-Myers Squibb, Chugai, Eisai, Janssen, Mitsubishi-Tanabe, Pfizer, Takeda, UCB, Consultant for: Abbott, Astellas, Bristol-Myers Squibb, Chugai, Eisai, Janssen, Mitsubishi-Tanabe, Pfizer, Takeda, UCB

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