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Efficacy and prognostic factors of treatment retention with intravenous abatacept for rheumatoid arthritis: 24-month results from an international, prospective, real-world study

1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14


  1. Rheumatologische Schwerpunktpraxis, University of Erlangen-Nuremberg, Germany.
  2. Schlosspark-Klinik University Medicine, Berlin, Germany.
  3. University of Siena, Italy.
  4. University Hospital, Heidelberg, Germany.
  5. VU University Medical Center/Jan van Breeman Research Institute, Amsterdam, The Netherlands.
  6. St. Josephs Hospital and McMaster University, Hamilton, Canada.
  7. Charité-Universitätsmedizin, Berlin, Germany.
  8. University of Freiburg, Germany.
  9. Evangelisches Krankenhaus, Vienna, Austria.
  10. Institute of Rheumatology, Prague, Czech Republic.
  11. Chiltern International, Neuilly, France.
  12. Docs International, Nanterre, France.
  13. Bristol-Myers Squibb, Munich, Germany.
  14. Bristol-Myers Squibb, Rueil-Malmaison, France.

2016 Vol.34, N°3
PI 0489, PF 0499
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PMID: 26966919 [PubMed]

Received: 16/08/2015
Accepted : 14/12/2015
In Press: 10/03/2016
Published: 30/05/2016


To evaluate retention of abatacept over 24 months in patients with rheumatoid arthritis (RA) in routine clinical practice across Europe and Canada.
ACTION (AbataCepT In rOutiNe clinical practice) was a prospective, observational, multicentre study of adult patients with moderate-to-severe RA who, at their physician’s discretion, initiated treatment with intravenous abatacept. Enrolment occurred from May 2008 to December 2010, with up to 30 months of follow-up. The primary endpoint was the abatacept retention rate over 24 months. Crude abatacept retention rate was estimated using the Kaplan-Meier method. Prognostic factors of abatacept retention in patients with ≥1 prior biologic failure were derived from a Cox proportional hazards regression model, accounting for clustered data.
A total of 1137 patients were enrolled (1573 patient-years on abatacept); most (89.2%) had experienced prior biologic failure. The overall crude abatacept retention rate at 24 months was 54.4% (95% confidence interval: 51.3, 57.4). Positivity for both rheumatoid factor and anti-cyclic citrullinated antibody, previous exposure to one or no anti-tumour necrosis factor agents, and cardiovascular comorbidity were prognostic of higher abatacept retention. Erythrocyte sedimentation rate ≥51 mm/hour and introduction of corticosteroid use at abatacept initiation were predictors of lower abatacept retention. Abatacept retention varied according to country. Abatacept was well tolerated without any unexpected safety signals.
In a real-world setting, intravenous abatacept treatment retention was more than 50% at 24 months. The identification of prognostic factors of abatacept retention could support individualised biologic treatment strategies in patients with moderate-to-severe RA.

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