gms | German Medical Science

45. Kongress der Deutschen Gesellschaft für Rheumatologie, 31. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie, 27. Jahrestagung der Gesellschaft für Kinder- und Jugendrheumatologie

06.09. - 09.09.2017, Stuttgart

Decrease in Corticosteroid Use in Patients with Rheumatoid Arthritis Who Initiated Intravenous Abatacept Treatment: Results From the 2-Year ACTION Study

Meeting Abstract

  • Rieke H.-E. Alten - Schlossparkklinik, Akademisches Lehrkrankenhaus der Charité - Universitätsmedizin Berlin, Innere Medizin II, Rheumatologie, klinische Immunologie und Osteologie, Berlin
  • X. Mariette - Paris-Sud University, Paris, France
  • Hanns-Martin Lorenz - Universitätsklinikum Heidelberg, Medizinische Klinik V, Sektion Rheumatologie, Heidelberg
  • Hubert Nüßlein - University of Erlangen-Nuremberg, Nuremberg
  • Mauro Galeazzi - University of Siena, Rheumatology Section, Siena, Italy
  • Frederico Navarro - Hospital Univesitario Virgen Macarena, Seville, Spain
  • Manuela Le Bars - Bristol-Myers Squibb, Rueil-Malmaison, France
  • Melanie Chartier - Bristol-Myers Squibb, Rueil-Malmaison, France
  • Julia Heitzmann - Excelya, Boulogne-Billancourt, France
  • Christiane Rauch - Bristol-Myers Squibb GmbH & Co. KGaA, München

Deutsche Gesellschaft für Rheumatologie. Deutsche Gesellschaft für Orthopädische Rheumatologie. Gesellschaft für Kinder- und Jugendrheumatologie. 45. Kongress der Deutschen Gesellschaft für Rheumatologie (DGRh), 31. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie (DGORh), 27. Jahrestagung der Gesellschaft für Kinder- und Jugendrheumatologie (GKJR). Stuttgart, 06.-09.09.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocRA.23

doi: 10.3205/17dgrh177, urn:nbn:de:0183-17dgrh1777

Veröffentlicht: 4. September 2017

© 2017 Alten et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

Background: ACTION (AbataCepT In rOutiNe clinical practice; NCT02109666) is a prospective, real-world study of patients with RA. Important concomitant treatment options for patients with RA include low-dose corticosteroids; however, corticosteroid dose should be tapered as soon as clinically feasible to reduce any safety concerns from continued use [1]. Decreased use of glucocorticoids has been previously reported for biologic-experienced patients who initiated abatacept [2]. We examined the use of concomitant corticosteroids in both biologic-naïve and biologic-experienced patients initiating abatacept.

Methods: ACTION is a 2-year, observational study of biologic-naïve and biologic-experienced patients with moderate-to-severe RA who initiated IV abatacept in routine clinical practice in Europe and Canada between May 2008 and December 2013. Concomitant corticosteroid use in patients initiating abatacept was analysed over 2 years. Corticosteroid doses were assessed using median area under the concentration–time curve (mg/day).

Results: A total of 2350/2364 patients (99.4%) were evaluable for the 2-year analysis; 673 (28.6%) were biologic naïve and 1677 (71.4%) biologic experienced. Of the biologic-experienced patients, 729 (43.4%) had received 1 and 948 (56.6%) had received ≥2 previous biologics. For biologic-naïve and biologic-experienced patients, respectively: mean (SD) age: 59.9 (12.7) and 56.9 (12.5) years; 496 (73.7%) and 1379 (82.2%) were women; RA duration: 7.2 (8.2) and 12.1 (9.1) years; baseline DAS28 (CRP): 4.8 and 5.0; and 621 (92.3%) and 1552 (92.5%) had previously received MTX. At abatacept initiation, concomitant corticosteroids were used in 455/673 (67.6%) biologic-naïve patients at a median dose of 5.0 mg/day and in 1190/1677 (71.0%) biologic-experienced patients at a median dose of 7.5 mg/day. At 2 years, the percentage of patients using corticosteroids decreased in both biologic-naïve and biologic-experienced cohorts (67.6 to 49.3% and 71.0 to 56.6%), respectively, and the median corticosteroid dose decreased to 6.0 mg/day in the biologic-experienced patients (Figure 1 [Fig. 1]). Of the 850 patients still on-study at 2 years with corticosteroid use data (286 biologic naïve, 564 biologic experienced), 197 biologic-naïve and 403 biologic-experienced patients had been taking corticosteroids at baseline, of whom 62 (31.5%) and 108 (26.8%), respectively, had stopped at 2 years.

Conclusion: This analysis showed a reduction in concomitant corticosteroid use in both biologic-naïve and biologic-experience patients with RA treated with abatacept, and that complete cessation of corticosteroids is possible in almost one-third of patients.


References

1.
Smolen JS, et al. Ann Rheum Dis. 2014;73:492–509.
2.
Alten R, et al. RMD Open. 2016;2:e000228.