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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)

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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.

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Authors and Affiliations

  1. Department of Emergency and Organ Trasplantation-Rheumatology Unit, University of Bari, Policlinico, Piazza G. Cesare 11, 70124, Bari, Italy

    Florenzo Iannone

  2. University Hospital, Geneva, Switzerland

    Delphine S. Courvoisier & Axel Finckh

  3. University Hospital, Strasbourg, France

    Jacques Eric Gottenberg

  4. Rheumatology Department Hospital Clínic of Barcelona, Barcelona, Spain

    Maria Victoria Hernandez

  5. Diakonhjemmet Hospital, Oslo, Norway

    Elisabeth Lie

  6. Reuma.pt, Santa Maria Hospital, Lisbon, Portugal

    Helena Canhão

  7. University Hospital, Prague, Czech Republic

    Karel Pavelka

  8. DANBIO and COPECARE, Center for Rheumatology and Spine Diseases, Glostrup Hospital, Glostrup, Denmark

    Merete Lund Hetland

  9. Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

    Merete Lund Hetland

  10. Lund University, Malmö, Sweden

    Carl Turesson

  11. Skåne University Hospital, Malmö, Sweden

    Carl Turesson

  12. Assistance Publique - Hôpitaux de Paris, Hôpitaux Universitaires Paris-Sud, INSERM U1012, Université Paris-Sud, Le Kremlin Bicêtre, France

    Xavier Mariette

  13. Institut of Rheumatology of Montreal, CHUM, Montreal, Canada

    Denis Choquette

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  1. Florenzo Iannone
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  2. Delphine S. Courvoisier
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  3. Jacques Eric Gottenberg
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  4. Maria Victoria Hernandez
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  5. Elisabeth Lie
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  6. Helena Canhão
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Correspondence to Florenzo Iannone.

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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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Iannone, F., Courvoisier, D.S., Gottenberg, J.E. 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). Clin Rheumatol 36, 773–779 (2017). https://doi.org/10.1007/s10067-016-3505-5

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