Background After demonstration of clinical outcome of abatacept (ABT) therapy, the use of ABT has become common practice in treating patients with rheumatoid arthritis (RA). The clinical trials has been reported that the efficacy was superior in biologic naïve patients than that in patients failed to prior biologics, but a few data exist regarding the differences between single biologic failure and multiple biologic failure.

Objectives The aim of this study was to assess whether the number of previous biologic therapy had any impact on the efficacy and safety of ABT in clinical routine practice.

Methods All eligible patients who underwent ABT therapy from October 2010 through to September 2014 (n=193) were registered in the Tsurumai Biologics Communication Registry (TBCR group), an RA research consortium that consists of Nagoya University Hospital and 18 affiliated institutes. We compared disease activities using DAS28 CRP between single biologic failure (single-BF group; n=118) and multiple biologic failure (multiple-BF group; n=75) at week 0, 12, 24, 52 104 and 156. Drug retention rates were calculated by Kaplan-Meier method. Furthermore, discontinuation due to inadequate responses (IRs) and adverse events (AEs) were evaluated.

Results In the baseline characteristics data, there was no significant difference between single-BF group and multiple-BF group, except for body weight (51.6 vs. 59.2kg). At any observation point, mean DAS28 CRP values were quite similar between two groups (data not shown). Drug retention rate at week 156 was 58.5% in single-BF group and 60.0% in multiple-BF group (Figure 1). The discontinuation rate due to IRs in single-BF group was slight higher than that in multiple-BF group (26.3 vs. 17.3%, Log-rank test p=0.127; Figure 2). Conversely, the discontinuation rate due to AEs was lower in single-BF group (4.20 vs. 12.0%, Log-rank test p=0.063; Figure 3).

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Conclusions This study demonstrated that the number of previous biologic therapy had less affected on retention rate of ABT. Interestingly, disease activities were quite similar between single biologic failure and multiple biologic failure. Our results suggest that ABT would be beneficial for patients with multi biologic failure.

Disclosure of Interest M. Hanabayashi: None declared, N. Takahashi: None declared, H. Miyake: None declared, Y. Yokota: None declared, T. Kojima Speakers bureau: Mitsubishi Tanabe Pharma Corporation, Takeda Pharma Corporation, Eisai Pharma Corporation, Chugai Pharma Corporation, abbvie, Bristol-Myers Squibb, Pfizer, Janssen Pharmaceutical K.K. and UCB Japan Co. Ltd., N. Ishiguro Speakers bureau: Mitsubishi Tanabe Pharma Corporation, Takeda Pharma Corporation, Eisai Pharma Corporation, Chugai Pharma Corporation, abbvie, Bristol-Myers Squibb, Pfizer, Janssen Pharmaceutical K.K. and UCB Japan Co. Ltd.