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Concomitant methotrexate has little effect on clinical outcomes of abatacept in rheumatoid arthritis: a propensity

Nobunori Takahashi1, Toshihisa Kojima2, Daihei Kida3

  • 1Department of Orthopedic Surgery and Rheumatology, Nagoya University Hospital, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan. nobunori@med.nagoya-u.ac.jp.

Clinical Rheumatology
|May 19, 2019
PubMed
Abstract

Insights

In rheumatoid arthritis, abatacept showed similar clinical outcomes whether or not patients also took methotrexate (MTX). This suggests abatacept is a viable treatment option, even for those who cannot take MTX.

Area of Science:

  • Rheumatology
  • Immunology
  • Clinical Pharmacology

Background:

  • Rheumatoid arthritis (RA) is a chronic autoimmune disease.
  • Abatacept is a biologic therapy used for RA treatment.
  • The role of concomitant methotrexate (MTX) with abatacept in RA management requires further clarification in real-world settings.

Purpose of the Study:

  • To compare the clinical outcomes of abatacept in rheumatoid arthritis patients with and without concomitant methotrexate (MTX) treatment.
  • To evaluate the efficacy and safety of abatacept in routine clinical practice.

Main Methods:

  • Retrospective cohort study utilizing a multicentre registry.
  • Propensity score matching was employed to create comparable groups of patients with (MTX(+)) and without (MTX(-)) concomitant MTX.
  • Clinical outcomes were assessed over a 52-week period.

Main Results:

  • Baseline characteristics were comparable between the MTX(-) and MTX(+) groups.
  • No significant differences were observed in drug retention rates, disease activity scores (DAS28-CRP), low disease activity rates, clinical remission rates, or EULAR response rates at 52 weeks.
  • Specific outcomes included drug retention (79.1%/80.5%), mean DAS28-CRP change (-1.35/-1.54), and good EULAR response (36.6%/41.1%) at 52 weeks.

Conclusions:

  • Concomitant methotrexate does not appear to significantly affect the clinical outcomes of abatacept treatment in RA patients with similar baseline characteristics.
  • Abatacept is a suitable treatment option in daily practice, particularly for RA patients with contraindications to MTX.
  • This study provides real-world evidence on abatacept efficacy, minimizing physician bias through registry data analysis.
Keywords:
AbataceptBiological DMARDsConcomitant drugMethotrexateMulticentre registryPropensity score matchingRheumatoid arthritis

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