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)

Clinical Rheumatology - Tập 36 - Trang 773-779 - 2016
Florenzo Iannone1, Delphine S. Courvoisier2, Jacques Eric Gottenberg3, Maria Victoria Hernandez4, Elisabeth Lie5, Helena Canhão6, Karel Pavelka7, Merete Lund Hetland8,9, Carl Turesson10,11, Xavier Mariette12, Denis Choquette13, Axel Finckh2
1Department of Emergency and Organ Trasplantation-Rheumatology Unit, University of Bari, Bari, Italy
2University Hospital, Geneva, Switzerland
3University Hospital, Strasbourg, France
4Rheumatology Department, Hospital Clínic of Barcelona, Barcelona, Spain
5Diakonhjemmet Hospital, Oslo, Norway
6Reuma.pt, Santa Maria Hospital, Lisbon, Portugal
7University Hospital, Prague, Czech Republic
8DANBIO and COPECARE, Center for Rheumatology and Spine Diseases, Glostrup Hospital, Glostrup, Denmark
9Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
10Lund University Malmö, Sweden
11Skåne University Hospital, Malmö, Sweden
12Assistance Publique - Hôpitaux de Paris, Hôpitaux Universitaires Paris-Sud, INSERM U1012, Université Paris-Sud, Le Kremlin Bicêtre, France
13Institut of Rheumatology of Montreal, CHUM, Montreal, Canada

Tóm tắt

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.

Tài liệu tham khảo

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