Efficacy of Abatacept Versus Tumor Necrosis Factor Inhibitors in Anti-citrullinated Protein Antibody-Positive Patients with Rheumatoid Arthritis: Results from a Korean Nationwide Biologics Registry

Min Jung Kim; Sun Kyung Lee; Sohee Oh; Hyoun Ah Kim; Yong Beom Park; Shin Seok Lee; Kichul Shin

doi:10.1007/s40744-022-00467-4

Efficacy of Abatacept Versus Tumor Necrosis Factor Inhibitors in Anti-citrullinated Protein Antibody-Positive Patients with Rheumatoid Arthritis: Results from a Korean Nationwide Biologics Registry

Min Jung Kim, Sun Kyung Lee, Sohee Oh, Hyoun Ah Kim, Yong Beom Park, Shin Seok Lee, Kichul Shin

Department of Internal Medicine

Research output: Contribution to journal › Article › peer-review

Abstract

Introduction: To compare the efficacy of abatacept and tumor necrosis factor inhibitor (TNFi) in patients with anti-citrullinated protein antibody (ACPA)-positive rheumatoid arthritis (RA) and identify those who benefit most from abatacept over TNFi. Methods: This observational study identified RA patients who were ACPA-positive and initiated abatacept or TNFi from the Korean College of Rheumatology Biologics and Targeted therapy registry. Propensity score (PS) matching was performed to balance baseline confounding in abatacept- or TNFi-treated patients. The major endpoints were changes in Clinical Disease Activity Index (CDAI) and achievement of CDAI remission/low disease activity after 1 year of treatment. Subgroup analysis was mainly performed stratified by prior biologics use. Results: A total of 291 PS-matched, ACPA-positive RA patients who initiated abatacept (n = 97) and TNFi (n = 194) were included. From baseline CDAI scores of 26.52 in the abatacept group and 26.38 in the TNFi group, the mean changes after 1 year were − 16.78 and − 13.61, respectively (difference − 3.17, p = 0.020). The proportion of patients achieving CDAI remission/low disease activity was 68.0% with abatacept and 52.6% with TNFi (p = 0.013). In the subgroup analysis, patients that were biologics-naïve had better improvement in CDAI after treatment with abatacept than TNFi (difference − 3.35, p = 0.021). Conclusions: This real-world study suggests that abatacept may have better clinical response compared to TNFi in patients with established ACPA-positive RA, especially in those that were biologics-naïve.

Original language	English
Pages (from-to)	1143-1155
Number of pages	13
Journal	Rheumatology and Therapy
Volume	9
Issue number	4
DOIs	https://doi.org/10.1007/s40744-022-00467-4
Publication status	Published - 2022 Aug

Bibliographical note

Funding Information:
We would like to thank Evo Alemao and Song-Wha Chae for sharing their insights for this study. The study was sponsored by Bristol-Myers Squibb. This funding source had no role in the design of this study nor did it have any role during its execution, analysis, interpretation of the data, or decision to submit results. The journal’s Rapid Service Fee was funded by the authors. Professional medical writing and editorial assistance was provided by Lola Parfitt, MRes, at Caudex, and was funded by Bristol-Myers Squibb. All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published. Conceptualization, KS; data curation, S-KL and SO; formal analysis, S-KL, SO and KS; funding acquisition, KS; writing—original draft, MJK and KS; writing—review and editing, H-AK, Y-BP, S-SL, and KS Min Jung Kim, Sun-Kyung Lee, Sohee Oh, Hyoun-Ah Kim, Yong-Beom Park, Shin-Seok Lee and Kichul Shin have nothing to disclose. They do not have any commercial benefits or financial interests in the study reported, or any other financial interests, which could create a potential conflict of interest or the appearance of a conflict of interest. This study was performed in accordance with the principles of the Declaration of Helsinki and Good Clinical Practice guidelines. All subjects provided written informed consent upon enrolment into the KOBIO registry. The study protocol was approved by the institutional review boards at BMC (26-2012-34). The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request. This work was presented as a poster communication in the Annual European Congress of Rheumatology (ARD, June 2018, Volume: 77, Pages 331).

Funding Information:
The study was sponsored by Bristol-Myers Squibb. This funding source had no role in the design of this study nor did it have any role during its execution, analysis, interpretation of the data, or decision to submit results. The journal’s Rapid Service Fee was funded by the authors.

Publisher Copyright:
© 2022, The Author(s).

All Science Journal Classification (ASJC) codes

Rheumatology
Immunology and Allergy

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10.1007/s40744-022-00467-4

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Kim, M. J., Lee, S. K., Oh, S., Kim, H. A., Park, Y. B., Lee, S. S., & Shin, K. (2022). Efficacy of Abatacept Versus Tumor Necrosis Factor Inhibitors in Anti-citrullinated Protein Antibody-Positive Patients with Rheumatoid Arthritis: Results from a Korean Nationwide Biologics Registry. Rheumatology and Therapy, 9(4), 1143-1155. https://doi.org/10.1007/s40744-022-00467-4

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title = "Efficacy of Abatacept Versus Tumor Necrosis Factor Inhibitors in Anti-citrullinated Protein Antibody-Positive Patients with Rheumatoid Arthritis: Results from a Korean Nationwide Biologics Registry",

abstract = "Introduction: To compare the efficacy of abatacept and tumor necrosis factor inhibitor (TNFi) in patients with anti-citrullinated protein antibody (ACPA)-positive rheumatoid arthritis (RA) and identify those who benefit most from abatacept over TNFi. Methods: This observational study identified RA patients who were ACPA-positive and initiated abatacept or TNFi from the Korean College of Rheumatology Biologics and Targeted therapy registry. Propensity score (PS) matching was performed to balance baseline confounding in abatacept- or TNFi-treated patients. The major endpoints were changes in Clinical Disease Activity Index (CDAI) and achievement of CDAI remission/low disease activity after 1 year of treatment. Subgroup analysis was mainly performed stratified by prior biologics use. Results: A total of 291 PS-matched, ACPA-positive RA patients who initiated abatacept (n = 97) and TNFi (n = 194) were included. From baseline CDAI scores of 26.52 in the abatacept group and 26.38 in the TNFi group, the mean changes after 1 year were − 16.78 and − 13.61, respectively (difference − 3.17, p = 0.020). The proportion of patients achieving CDAI remission/low disease activity was 68.0% with abatacept and 52.6% with TNFi (p = 0.013). In the subgroup analysis, patients that were biologics-na{\"i}ve had better improvement in CDAI after treatment with abatacept than TNFi (difference − 3.35, p = 0.021). Conclusions: This real-world study suggests that abatacept may have better clinical response compared to TNFi in patients with established ACPA-positive RA, especially in those that were biologics-na{\"i}ve.",

author = "Kim, {Min Jung} and Lee, {Sun Kyung} and Sohee Oh and Kim, {Hyoun Ah} and Park, {Yong Beom} and Lee, {Shin Seok} and Kichul Shin",

note = "Funding Information: We would like to thank Evo Alemao and Song-Wha Chae for sharing their insights for this study. The study was sponsored by Bristol-Myers Squibb. This funding source had no role in the design of this study nor did it have any role during its execution, analysis, interpretation of the data, or decision to submit results. The journal{\textquoteright}s Rapid Service Fee was funded by the authors. Professional medical writing and editorial assistance was provided by Lola Parfitt, MRes, at Caudex, and was funded by Bristol-Myers Squibb. All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published. Conceptualization, KS; data curation, S-KL and SO; formal analysis, S-KL, SO and KS; funding acquisition, KS; writing—original draft, MJK and KS; writing—review and editing, H-AK, Y-BP, S-SL, and KS Min Jung Kim, Sun-Kyung Lee, Sohee Oh, Hyoun-Ah Kim, Yong-Beom Park, Shin-Seok Lee and Kichul Shin have nothing to disclose. They do not have any commercial benefits or financial interests in the study reported, or any other financial interests, which could create a potential conflict of interest or the appearance of a conflict of interest. This study was performed in accordance with the principles of the Declaration of Helsinki and Good Clinical Practice guidelines. All subjects provided written informed consent upon enrolment into the KOBIO registry. The study protocol was approved by the institutional review boards at BMC (26-2012-34). The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request. This work was presented as a poster communication in the Annual European Congress of Rheumatology (ARD, June 2018, Volume: 77, Pages 331). Funding Information: The study was sponsored by Bristol-Myers Squibb. This funding source had no role in the design of this study nor did it have any role during its execution, analysis, interpretation of the data, or decision to submit results. The journal{\textquoteright}s Rapid Service Fee was funded by the authors. Publisher Copyright: {\textcopyright} 2022, The Author(s).",

year = "2022",

month = aug,

doi = "10.1007/s40744-022-00467-4",

language = "English",

volume = "9",

pages = "1143--1155",

journal = "Rheumatology and Therapy",

issn = "2198-6576",

publisher = "Adis International Ltd",

number = "4",

}

Efficacy of Abatacept Versus Tumor Necrosis Factor Inhibitors in Anti-citrullinated Protein Antibody-Positive Patients with Rheumatoid Arthritis : Results from a Korean Nationwide Biologics Registry. / Kim, Min Jung; Lee, Sun Kyung; Oh, Sohee et al.

In: Rheumatology and Therapy, Vol. 9, No. 4, 08.2022, p. 1143-1155.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Efficacy of Abatacept Versus Tumor Necrosis Factor Inhibitors in Anti-citrullinated Protein Antibody-Positive Patients with Rheumatoid Arthritis

T2 - Results from a Korean Nationwide Biologics Registry

AU - Kim, Min Jung

AU - Lee, Sun Kyung

AU - Oh, Sohee

AU - Kim, Hyoun Ah

AU - Park, Yong Beom

AU - Lee, Shin Seok

AU - Shin, Kichul

N1 - Funding Information: We would like to thank Evo Alemao and Song-Wha Chae for sharing their insights for this study. The study was sponsored by Bristol-Myers Squibb. This funding source had no role in the design of this study nor did it have any role during its execution, analysis, interpretation of the data, or decision to submit results. The journal’s Rapid Service Fee was funded by the authors. Professional medical writing and editorial assistance was provided by Lola Parfitt, MRes, at Caudex, and was funded by Bristol-Myers Squibb. All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published. Conceptualization, KS; data curation, S-KL and SO; formal analysis, S-KL, SO and KS; funding acquisition, KS; writing—original draft, MJK and KS; writing—review and editing, H-AK, Y-BP, S-SL, and KS Min Jung Kim, Sun-Kyung Lee, Sohee Oh, Hyoun-Ah Kim, Yong-Beom Park, Shin-Seok Lee and Kichul Shin have nothing to disclose. They do not have any commercial benefits or financial interests in the study reported, or any other financial interests, which could create a potential conflict of interest or the appearance of a conflict of interest. This study was performed in accordance with the principles of the Declaration of Helsinki and Good Clinical Practice guidelines. All subjects provided written informed consent upon enrolment into the KOBIO registry. The study protocol was approved by the institutional review boards at BMC (26-2012-34). The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request. This work was presented as a poster communication in the Annual European Congress of Rheumatology (ARD, June 2018, Volume: 77, Pages 331). Funding Information: The study was sponsored by Bristol-Myers Squibb. This funding source had no role in the design of this study nor did it have any role during its execution, analysis, interpretation of the data, or decision to submit results. The journal’s Rapid Service Fee was funded by the authors. Publisher Copyright: © 2022, The Author(s).

PY - 2022/8

Y1 - 2022/8

N2 - Introduction: To compare the efficacy of abatacept and tumor necrosis factor inhibitor (TNFi) in patients with anti-citrullinated protein antibody (ACPA)-positive rheumatoid arthritis (RA) and identify those who benefit most from abatacept over TNFi. Methods: This observational study identified RA patients who were ACPA-positive and initiated abatacept or TNFi from the Korean College of Rheumatology Biologics and Targeted therapy registry. Propensity score (PS) matching was performed to balance baseline confounding in abatacept- or TNFi-treated patients. The major endpoints were changes in Clinical Disease Activity Index (CDAI) and achievement of CDAI remission/low disease activity after 1 year of treatment. Subgroup analysis was mainly performed stratified by prior biologics use. Results: A total of 291 PS-matched, ACPA-positive RA patients who initiated abatacept (n = 97) and TNFi (n = 194) were included. From baseline CDAI scores of 26.52 in the abatacept group and 26.38 in the TNFi group, the mean changes after 1 year were − 16.78 and − 13.61, respectively (difference − 3.17, p = 0.020). The proportion of patients achieving CDAI remission/low disease activity was 68.0% with abatacept and 52.6% with TNFi (p = 0.013). In the subgroup analysis, patients that were biologics-naïve had better improvement in CDAI after treatment with abatacept than TNFi (difference − 3.35, p = 0.021). Conclusions: This real-world study suggests that abatacept may have better clinical response compared to TNFi in patients with established ACPA-positive RA, especially in those that were biologics-naïve.

AB - Introduction: To compare the efficacy of abatacept and tumor necrosis factor inhibitor (TNFi) in patients with anti-citrullinated protein antibody (ACPA)-positive rheumatoid arthritis (RA) and identify those who benefit most from abatacept over TNFi. Methods: This observational study identified RA patients who were ACPA-positive and initiated abatacept or TNFi from the Korean College of Rheumatology Biologics and Targeted therapy registry. Propensity score (PS) matching was performed to balance baseline confounding in abatacept- or TNFi-treated patients. The major endpoints were changes in Clinical Disease Activity Index (CDAI) and achievement of CDAI remission/low disease activity after 1 year of treatment. Subgroup analysis was mainly performed stratified by prior biologics use. Results: A total of 291 PS-matched, ACPA-positive RA patients who initiated abatacept (n = 97) and TNFi (n = 194) were included. From baseline CDAI scores of 26.52 in the abatacept group and 26.38 in the TNFi group, the mean changes after 1 year were − 16.78 and − 13.61, respectively (difference − 3.17, p = 0.020). The proportion of patients achieving CDAI remission/low disease activity was 68.0% with abatacept and 52.6% with TNFi (p = 0.013). In the subgroup analysis, patients that were biologics-naïve had better improvement in CDAI after treatment with abatacept than TNFi (difference − 3.35, p = 0.021). Conclusions: This real-world study suggests that abatacept may have better clinical response compared to TNFi in patients with established ACPA-positive RA, especially in those that were biologics-naïve.

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Efficacy of Abatacept Versus Tumor Necrosis Factor Inhibitors in Anti-citrullinated Protein Antibody-Positive Patients with Rheumatoid Arthritis: Results from a Korean Nationwide Biologics Registry

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