Seropositivity and Disability Predict Remission after IV Abatacept in Patients with RA

In a study of patients with rheumatoid arthritis (RA), researchers sought to identify baseline factors that are predictive of treatment remission after a regimen of intravenous (IV) abatacept. These findings were presented at the American College of Rheumatology (ACR) Convergence 2021.

This study was a post hoc analysis of the ACTION trial, an international observational study evaluating IV abatacept. Adult patients (aged ≥18 years) from ACTION with moderate-to-severe RA who achieved remission at 12 months were included. Remission was defined as a score of less than 2.6 in Disease Activity Score-28 for Rheumatoid Arthritis with C Reactive Protein (DAS28-CRP), 2.8 in the Clinical Disease Activity Index (CDAI), or 3.3 in the Simplified Disease Activity Index (SDAI).

In total, 2,260 patients were evaluated, including 643 patients who received first-line abatacept and 1,617 patients who received second-line or later therapy.

Overall, seropositivity was associated with increased likelihood of DAS28-CRP and CDAI remission. Less severe disability, defined via Health Assessment Questionnaire disability index (HAQ-DI), was also associated with DAS28-CRP and SDAI remission. For DAS28-CRP remission specifically, likelihood was higher among patients treated on their second or later line of therapy, who had lower body mass index, less severe comorbidity, and prior tumor necrosis factor inhibitor use (vs. other biologics). CDAI and SDAI remission were also more common in patients receiving abatacept as their second or later line of therapy.

“This post hoc, multivariate analysis of the ACTION study showed several baseline factors, including seropositive RA and less severe disability (HAQ-DI), to be associated with remission at 12 months for patients treated with IV abatacept,” wrote the authors concluded. “These data support the earlier use of abatacept in patients with seropositive RA.”

Source: Alten R, et al. Baseline Characteristics Predictive of Remission in Patients with RA Following Treatment with IV Abatacept: Post Hoc Analysis of a Real-world Observational Study. Arthritis Rheumatol. 2021;73(suppl 10). Presented at ACR Convergence 2021 (Virtual), Nov. 5-9, 2021.