Abatacept Monotherapy Versus Abatacept Plus Methotrexate for Treatment-Refractory Rheumatoid Arthritis.
Journal
American journal of therapeutics
ISSN: 1536-3686
Titre abrégé: Am J Ther
Pays: United States
ID NLM: 9441347
Informations de publication
Date de publication:
Historique:
pubmed:
13
10
2017
medline:
16
11
2019
entrez:
13
10
2017
Statut:
ppublish
Résumé
Methotrexate combination therapy improves abatacept efficacy as a first-line biologic agent for the treatment of rheumatoid arthritis, but it is unclear when abatacept is used later on, particularly after non-TNF inhibitor (TNFi) failure. The objective of this study was to determine whether treatment response after non-TNFi inadequate response is different in patients with rheumatoid arthritis (RA) treated with abatacept in combination with or not with methotrexate. Patients treated with abatacept monotherapy or in combination with methotrexate after non-TNFi failure were included. Data from 46 patients aged 56 years [49-61] with 12 years [8-16] of disease duration were examined. Rituximab was the treatment used in the previous line for 75.0% of the combination therapy group (15/20) and 34.6% (9/26) in the monotherapy group. At 12 months, 38.5% (10/26) of patients were in good-to-moderate EULAR response in the monotherapy group compared with 25.0% (5/20) in the combination therapy group (P = 0.33). Treatment persistence at 12 months was 61.5% (16/26) in the monotherapy group and 35.0% (7/20) in the combination therapy group (P = 0.07). Adding methotrexate to abatacept did not improve treatment response in patients with RA after non-TNFi inadequate response.
Sections du résumé
BACKGROUND
BACKGROUND
Methotrexate combination therapy improves abatacept efficacy as a first-line biologic agent for the treatment of rheumatoid arthritis, but it is unclear when abatacept is used later on, particularly after non-TNF inhibitor (TNFi) failure.
STUDY QUESTION
OBJECTIVE
The objective of this study was to determine whether treatment response after non-TNFi inadequate response is different in patients with rheumatoid arthritis (RA) treated with abatacept in combination with or not with methotrexate.
METHODS
METHODS
Patients treated with abatacept monotherapy or in combination with methotrexate after non-TNFi failure were included.
RESULTS
RESULTS
Data from 46 patients aged 56 years [49-61] with 12 years [8-16] of disease duration were examined. Rituximab was the treatment used in the previous line for 75.0% of the combination therapy group (15/20) and 34.6% (9/26) in the monotherapy group. At 12 months, 38.5% (10/26) of patients were in good-to-moderate EULAR response in the monotherapy group compared with 25.0% (5/20) in the combination therapy group (P = 0.33). Treatment persistence at 12 months was 61.5% (16/26) in the monotherapy group and 35.0% (7/20) in the combination therapy group (P = 0.07).
CONCLUSIONS
CONCLUSIONS
Adding methotrexate to abatacept did not improve treatment response in patients with RA after non-TNFi inadequate response.
Identifiants
pubmed: 29023282
doi: 10.1097/MJT.0000000000000645
doi:
Substances chimiques
Antirheumatic Agents
0
Abatacept
7D0YB67S97
Methotrexate
YL5FZ2Y5U1
Types de publication
Comparative Study
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM