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Body mass does not impact the clinical response to intravenous abatacept in patients with rheumatoid arthritis. Analysis from the "pan-European registry collaboration for abatacept (PANABA)

Iannone, Florenzo
Author Iannone, Florenzo Department of Emergency and Organ Trasplantation-Rheumatology Unit, University of Bari, Policlinico, Piazza G. Cesare 11, 70124, Bari, Italy. florenzo.iannone@uniba.it
Courvoisier, Delphine S
Author Courvoisier, Delphine S University Hospital, Geneva, Switzerland
Gottenberg, Jacques Eric
Author Gottenberg, Jacques Eric University Hospital, Strasbourg, France
Hernandez, Maria Victoria
Author Hernandez, Maria Victoria Rheumatology Department Hospital Clínic of Barcelona, Barcelona, Spain
Lie, Elisabeth
Author Lie, Elisabeth Diakonhjemmet Hospital, Oslo, Norway
Canhão, Helena
Author Canhão, Helena Reuma.pt, Santa Maria Hospital, Lisbon, Portugal
Pavelka, Karel
Author Pavelka, Karel University Hospital, Prague, Czech Republic
Hetland, Merete Lund
Author Hetland, Merete Lund DANBIO and COPECARE, Center for Rheumatology and Spine Diseases, Glostrup Hospital, Glostrup, Denmark Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
Turesson, Carl
Author Turesson, Carl Lund University, Malmö, Sweden Skåne University Hospital, Malmö, Sweden
Mariette, Xavier
Author Mariette, Xavier Assistance Publique - Hôpitaux de Paris, Hôpitaux Universitaires Paris-Sud, INSERM U1012, Université Paris-Sud, Le Kremlin Bicêtre, France
Choquette, Denis
Author Choquette, Denis Institut of Rheumatology of Montreal, CHUM, Montreal, Canada
Finckh, Axel
Author Finckh, Axel University Hospital, Geneva, Switzerland

Clinical rheumatology. 2017 Apr ; 36 (4) : 773-779. [epub] 20161214

Clin Rheumatol
ISSN 1434-9949 | 0770-3198
Source

Language English Country Germany Media print-electronic

Document type Journal Article, Multicenter Study

Persistent link https://www.medvik.cz/link/pmid27966068

PubMed 27966068
DOI 10.1007/s10067-016-3505-5
PII: 10.1007/s10067-016-3505-5
Knihovny.cz E-resources

Keywords
Abatacept, Body mass index, Drug survival, Rheumatoid arthritis,
MeSH
Abatacept administration & dosage adverse effects MeSH
Antirheumatic Agents administration & dosage adverse effects MeSH
Adult MeSH
Body Mass Index * MeSH
Remission Induction MeSH
Kaplan-Meier Estimate MeSH
Middle Aged MeSH
Humans MeSH
Multivariate Analysis MeSH
Proportional Hazards Models MeSH
Prospective Studies MeSH
Registries MeSH
Arthritis, Rheumatoid drug therapy MeSH
Rheumatoid Factor blood MeSH
Aged MeSH
Treatment Outcome MeSH
Check Tag
Adult MeSH
Middle Aged MeSH
Humans MeSH
Male MeSH
Aged MeSH
Female MeSH
Publication type
Journal Article MeSH
Multicenter Study MeSH
Geographicals
Europe MeSH
Names of Substances
Abatacept MeSH
Antirheumatic Agents MeSH
Rheumatoid Factor MeSH

Some evidences suggest that obesity impairs the effectiveness of TNF inhibitors. We examined the impact of body mass index (BMI) on the clinical effectiveness of abatacept in rheumatoid arthritis (RA) patients. This is a pooled analysis of 10 prospective cohorts of RA patients. All patients with available BMI were included in this study. The primary endpoint was drug retention of abatacept in the different BMI categories. Multivariable Cox regression was used to estimate hazard ratios (HRs) for drug discontinuation. A secondary endpoint was EULAR/LUNDEX response rates at 6/12 months. Of the 2015 RA patients initiating therapy with IV abatacept, 380 (18.9%) were classified as obese. Obese patients had more functional disability, and were less often RF positive. The median abatacept retention time was 1.91 years for obese RA patients compared to 2.12 years for non-obese patients (p = 0.15). The risk of abatacept discontinuation was not significantly different for overweight (HR 1.03 (95% CI 0.89-1.19)), or for obese (HR 1.08 (95% CI 0.89-1.30)) compared to normal-weight patients. Rheumatoid factor positivity reduced the risk of abatacept discontinuation (HR 0.83 (95% CI 0.72-0.95)), while previous biologic therapy was positively associated with drug interruption (HRs increasing from 1.68 to 2.16 with the line of treatments). Obese and non-obese patients attained similar rates of EULAR/LUNDEX clinical response at 6/12 months. Drug retention and clinical response rates to abatacept do not seem to be decreased by obesity in RA patients.

Assistance Publique Hôpitaux de Paris Hôpitaux Universitaires Paris Sud INSERM U1012 Université Paris Sud Le Kremlin Bicêtre France

DANBIO and COPECARE Center for Rheumatology and Spine Diseases Glostrup Hospital Glostrup Denmark

Department of Clinical Medicine Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark

Department of Emergency and Organ Trasplantation Rheumatology Unit University of Bari Policlinico Piazza G Cesare 11 70124 Bari Italy

Diakonhjemmet Hospital Oslo Norway

Institut of Rheumatology of Montreal CHUM Montreal Canada

Lund University Malmö Sweden

Reuma pt Santa Maria Hospital Lisbon Portugal

Rheumatology Department Hospital Clínic of Barcelona Barcelona Spain

Skåne University Hospital Malmö Sweden

University Hospital Geneva Switzerland

University Hospital Prague Czech Republic