ABSTRACT

Objective:

The aim of this study was to compare the intravenous (IV) and subcutaneous (SC) applications of abatacept in terms of effectiveness in the treatment of rheumatoid arthritis (RA).

Methods:

Patients with RA who received IV or SC abatacept therapies at the Department of Rheumatology, Fırat University, between 2014 and 2017 were enrolled in the study. Laboratory and clinical data of patients including disease activity indices [DAS28-CRP (DAS; Disease Activity score), CDAI (Clinical Disease Activity index), functional status (HAQ; health assessment questionnaire), Visual Analog scale for pain (VAS-pain), patient’s global assessment (VAS-global), physician’s global assessment (VAS-physician), number of swollen and sensitive joints] were evaluated, retrospectively.

Results:

The number of patients receiving abatacept therapy was 35. 57.1% of the patients were using IV (n=20) and 42.9% were using SC (n=15) abatacept. The rate of continuing abatacept treatment was 60% in the IV abatacept group (n=12) and 53.3% in the SC abatacept group (n=8) (p=0.693). There was no statistical difference between the two groups in terms of DAS28-CRP, CDAI, VAS-pain, VAS-global, VAS-physician, and HAQ scores.

Conclusion:

In this study, it was found that there was no statistically significant difference in terms of efficacy between the IV and SC applications of the abatacept therapy used in the treatment of RA.

References

1Smolen JS, Aletaha D, McInnes IB. Rheumatoid arthritis. Lancet 2016;388:2023-38.

2Smolen JS, Landewe R, Bijlsma J, et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2016 update. Annals of the rheumatic diseases 2017;76:960-77.

3Sandigursky S, Silverman GJ, Mor A. Targeting the programmed cell death-1 pathway in rheumatoid arthritis. Autoimmunity reviews 2017;16:767-73.

4Blair HA, Deeks ED. Abatacept: A Review in Rheumatoid Arthritis. Drugs 2017;77:1221-33.

5Genovese MC, Covarrubias A, Leon G, et al. Subcutaneous abatacept versus intravenous abatacept: a phase IIIb noninferiority study in patients with an inadequate response to methotrexate. Arthritis Rheum 2011;63:2854-64.

6Kaine J, Gladstein G, Strusberg I, et al. Evaluation of abatacept administered subcutaneously in adults with active rheumatoid arthritis: impact of withdrawal and reintroduction on immunogenicity, efficacy and safety (phase Iiib ALLOW study). Ann Rheum Dis 2012;71:38-44.

7Keystone EC, Kremer JM, Russell A, et al. Abatacept in subjects who switch from intravenous to subcutaneous therapy: results from the phase IIIb ATTUNE study. Ann Rheum Dis 2012;71:857-61.

8Matsubara T, Inoue H, Iwahashi M, Yamazaki A, Takeuchi T, Japan Abatacept Study Group. A multi-center, double-dummy, double-blind study of subcutaneous (SC) abatacept (ABA) compared with intraveneous (iv) ABA in Japanese rheumatoid arthritis patients with inadequate response to methotrexate. Ann Rheum Dis. 2012;71 Suppl. 3:197.

9Genovese MC, Pacheco Tena C, Covarrubias A, et al. SC vs IV abatacept in RA: post-hoc efficacy analysis of long-term ACQUIRE (SC) data with AIM (IV) data. Ann Rheum Dis. 2012;71 Suppl. 3:378.

10Iwahashi M, Inoue H, Matsubara T, et al. Efficacy, safety, pharmacokinetics and immunogenicity of abatacept administered subcutaneously or intravenously in Japanese patients with rheumatoid arthritis and inadequate response to methotrexate: a Phase II/III, randomized study. Mod Rheumatol 2014;24:885-91.

11Strand V, Balsa A, Al-Saleh J, et al. Immunogenicity of Biologics in Chronic Inflammatory Diseases: A Systematic Review. BioDrugs 2017;31:299-316.

Subcutaneous and intravenous applications of abatacept therapy used in the treatment of rheumatoid arthritis show similar efficacy

ABSTRACT

References