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Title

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)

Authors
Iannone, Florenzo
Courvoisier, Delphine S
Gottenberg, Jacques Eric
Hernandez, Maria Victoria
Lie, Elisabeth
Canhão, Helena
Pavelka, Karel
Hetland, Merete Lund
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Published in Clinical Rheumatology. 2017, vol. 36, no. 4, p. 773-779
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/administration & dosage/adverse effectsAdultAgedAntirheumatic Agents/administration & dosage/adverse effectsArthritis, Rheumatoid/drug therapyBody Mass IndexEuropeFemaleHumansKaplan-Meier EstimateMaleMiddle AgedMultivariate AnalysisProportional Hazards ModelsProspective StudiesRegistriesRemission InductionRheumatoid Factor/bloodTreatment Outcome
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PMID: 27966068
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Research group Mécanisme de l'inflammation articulaire (44)
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IANNONE, Florenzo et al. 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). In: Clinical Rheumatology, 2017, vol. 36, n° 4, p. 773-779. doi: 10.1007/s10067-016-3505-5 https://archive-ouverte.unige.ch/unige:110908

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Deposited on : 2018-11-16

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