First-line abatacept improves disease remission in RA

The use of abatacept as a first-line biologic treatment appears to result in greater remission in rheumatoid arthritis (RA), especially if the drug is used continuously, as shown in a real-world study from Taiwan.

The analysis included 212 RA patients aged ≥20 years (mean age 57.5 years, 83.0 percent female, mean BMI 23.2 kg/m², median disease duration 4.0 years) who received abatacept in real-world practice. Of the patients, 143 (67.5 percent) were new abatacept users and 69 (32.5 percent) were ongoing users; 142 (67.0 percent) were naïve to biological disease-modifying antirheumatic drug (bDMARD) and 70 (33.0 percent) were bDMARD-experienced.

In the entire population, the primary endpoint of abatacept retention rate at 24 months was 59.9 percent (95 percent confidence interval 53.0–66.6). The highest retention rate was recorded among patients who were ongoing users of abatacept and were bDMARD-naïve (76.3 percent), of which 31.6 percent achieved low disease activity or remission after 2 years.

Meanwhile, previous treatment with bDMARDs was associated with a twofold greater risk of abatacept discontinuation (hazard ratio, 1.99; p=0.002). Drug switch (11.3 percent) was the most common reason for abatacept discontinuation, followed by loss to follow-up (6.1 percent).

As for safety, abatacept was well-tolerated with no unexpected safety signals.