How Does Abatacept Compare To Other bDMARDs in Rheumatoid Arthritis Treatment?

A study evaluated the use of biologic disease-modifying antirheumatic drugs (bDMARDs) in the treatment of rheumatoid arthritis (RA), and compared outcomes between patients taking abatacept compared to other bDMARDs.

The retrospective study included patients with RA treated with abatacept as any line of therapy (LOT) at four different centers in the UK between January 2013 and December 2017.

Final analysis consisted of 213 patients who received up to eight LOTs. The mean age was 55.2 years, and most patients were female (71.4%). The median disease duration prior to initiating bDMARD therapy was 3.9 years (interquartile range, 2.1-8.5 years). Receipt of abatacept or any bDMARD was correlated with reduced six-month disease activity score for 28 joints (DAS28) erythrocyte sedimentation rate and DAS2 C-reactive protein (DAS28-CRP) scores. European League Against Rheumatism (EULAR) responses, measured as good, moderate, or no response, were better for patients when receiving abatacept compared to when receiving other bDMARDs, at six months (22.8% vs. 16.6%, 41.3% vs. 41.4%, and 35.9% vs. 42.1%, respectively) and one year (27.9% vs. 21.2%, 36.1% vs. 34.5%, and 36.1% vs. 44.2%, respectively).

The 68 patients who received abatacept as their first LOT were on treatment much longer compared to those receiving other bDMARDs (53.4 months vs. 17.4 months, P<0.01), and this was similar for the second LOT. Patients receiving other bDMARDs who stopped after six months were more likely to sustain an infection requiring antibiotics compared to patients receiving abatacept.

The study was published in BMC Rheumatology.

The researchers acknowledged the impact of the COVID-19 pandemic on treatment as well.

“The rheumatology community is working to optimise disease management strategies and transition to telehealth. Early research suggests the risk of serious complications from COVID-19 is not increased for patients treated with bDMARDs or targeted synethic DMARDs. However, preventative withdrawal of these treatments, which may occur at the time of COVID-19 symptom onset, should be avoided due to the increased risk of relapse and morbidity. Future research should consider how abatacept and other bDMARDs are used in RA management during and after the pandemic,” they recommended.