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Clinical Rheumatology

, Volume 36, Issue 4, pp 773–779 | Cite as

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)

  • Florenzo Iannone
  • Delphine S. Courvoisier
  • Jacques Eric Gottenberg
  • Maria Victoria Hernandez
  • Elisabeth Lie
  • Helena Canhão
  • Karel Pavelka
  • Merete Lund Hetland
  • Carl Turesson
  • Xavier Mariette
  • Denis Choquette
  • Axel Finckh
Original Article

Abstract

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.

Keywords

Abatacept Body mass index Drug survival Rheumatoid arthritis 

Notes

Compliance with ethical standards

Disclosures

None.

Funding

The study was supported by an unrestricted research grant from Bristol–Myers Squibb (BMS). BMS had no role in the interpretation of the data nor in the decision to publish or not the results.

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Copyright information

© International League of Associations for Rheumatology (ILAR) 2016

Authors and Affiliations

  • Florenzo Iannone
    • 1
  • Delphine S. Courvoisier
    • 2
  • Jacques Eric Gottenberg
    • 3
  • Maria Victoria Hernandez
    • 4
  • Elisabeth Lie
    • 5
  • Helena Canhão
    • 6
  • Karel Pavelka
    • 7
  • Merete Lund Hetland
    • 8
    • 9
  • Carl Turesson
    • 10
    • 11
  • Xavier Mariette
    • 12
  • Denis Choquette
    • 13
  • Axel Finckh
    • 2
  1. 1.Department of Emergency and Organ Trasplantation-Rheumatology UnitUniversity of BariBariItaly
  2. 2.University HospitalGenevaSwitzerland
  3. 3.University HospitalStrasbourgFrance
  4. 4.Rheumatology Department Hospital Clínic of BarcelonaBarcelonaSpain
  5. 5.Diakonhjemmet HospitalOsloNorway
  6. 6.Reuma.pt, Santa Maria HospitalLisbonPortugal
  7. 7.University HospitalPragueCzech Republic
  8. 8.DANBIO and COPECARE, Center for Rheumatology and Spine DiseasesGlostrup HospitalGlostrupDenmark
  9. 9.Department of Clinical Medicine, Faculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark
  10. 10.Lund UniversityMalmöSweden
  11. 11.Skåne University HospitalMalmöSweden
  12. 12.Assistance Publique - Hôpitaux de Paris, Hôpitaux Universitaires Paris-Sud, INSERM U1012Université Paris-SudLe Kremlin BicêtreFrance
  13. 13.Institut of Rheumatology of MontrealCHUMMontrealCanada

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