Abatacept is Efficacious in the Treatment of Older Patients with csDMARD-Refractory Rheumatoid Arthritis: A Prospective, Multicenter, Observational Study

Rheumatology and Therapy - Tập 8 - Trang 1585-1601 - 2021
Sei Muraoka1, Zento Yamada1, Mai Kawazoe1, Wataru Hirose2, Hajime Kono3, Shinsuke Yasuda4,5, Yukiko Komano6, Hiroshi Kawano7, Toshihiko Hidaka8, Shusaku Nakashima9, Tsuyoshi Kasama10, Tamio Teramoto11, Toshihiro Nanki1
1Division of Rheumatology, Department of Internal Medicine, Toho University School of Medicine, Tokyo, Japan
2Hirose Clinic of Rheumatology, Saitama, Japan
3Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan
4Department of Rheumatology, Endocrinology and Nephrology, Graduate School of Medicine and Faculty of Medicine, Hokkaido University, Sapporo, Japan
5Department of Rheumatology, Tokyo Medical and Dental University, Tokyo, Japan
6Department of Rheumatology, Jujo Takeda Rehabilitation Hospital, Kyoto, Japan
7Department of Respiratory Medicine and Rheumatology, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
8Institute of Rheumatology, Zenjinkai Miyazaki-Zenjinkai Hospital, Miyazaki, Japan
9Division of Hematology, Rheumatology and Respiratory Medicine, Department of Internal Medicine, Faculty of Medicine, Kagawa University, Takamatsu, Japan
10Division of Rheumatology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
11Teikyo Academic Research Center, Teikyo University School of Medicine, Tokyo, Japan

Tóm tắt

Abatacept efficacy in older patients with rheumatoid arthritis (RA) has been primarily demonstrated via retrospective comparisons with younger patients. The objective of this study was to compare efficacy of abatacept in older vs. younger patients with RA, and efficacy of abatacept with that of conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs) in both age groups. This prospective, multicenter, observational study (UMIN000014913) enrolled csDMARD-refractory patients without previous biological DMARD treatment. Abatacept (A) or csDMARDs (C) were administered at the treating physician’s discretion to older (O, ≥ 65 years) and younger (Y, 20–64 years) patients, producing AO, AY, CO, and CY groups. Clinical efficacy after 24 weeks was evaluated using European League Against Rheumatism (EULAR) erythrocyte sedimentation rate response criteria. Overall, 202 patients were evaluated. Compared with the CO group, more patients in the AO group achieved a EULAR good or moderate response (p < 0.0001). Compared with the CY group, more patients in the AY group achieved a EULAR good or moderate response (p < 0.01). Similar proportions of patients in the AO and AY groups achieved a EULAR good response or a good or moderate response. Few adverse events were reported. This prospective study demonstrated that abatacept is efficacious and safe in older patients with RA and a history of being refractory to csDMARDs. Abatacept was shown to be more efficacious than adding or switching to a new csDMARD in both younger and older csDMARD-refractory patients with RA. UMIN000014913.

Tài liệu tham khảo

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