ASCORE study reports improved abatacept retention and clinical response rates in patients who received early subcutaneous abatacept

Recently, the findings of the international ASCORE study published in Clinical Rheumatology found that the 2-year retention rate for subcutaneous (SC) abatacept was 47%, accompanied by favorable clinical outcomes and good tolerability. Patients who received abatacept as an earlier-line biologic drug treatment and those with seropositive rheumatoid arthritis (RA) experienced higher rates of abatacept retention and clinical response compared to patients who received it later in their treatment journey.

Dr. Alten and colleagues conducted a cohort study to evaluate the effectiveness of subcutaneous abatacept in the treatment of RA. The study, known as the Abatacept SubCutaneous in Routine clinical practicE (ASCORE), aimed to assess the 2-year retention, safety, and efficacy of SC abatacept in Germany, Austria, and Switzerland. The 2-year abatacept retention rate for the pooled cohort was 47.6%, with the highest retention rates (50.5%) observed in individuals who had no prior exposure to biologics. Regardless of the treatment line, patients who were seropositive for both ACPA and RF (+ / +) at baseline had a greater 2-year abatacept retention rate than patients who were either single or double seropositive (+ / +). When compared to patients who had received one or two prior biologics, a higher percentage of biologic-naive patients were in low-disease activity or remission at two years.

In a retrospective cohort study conducted in 2019, the real-life experience of SC abatacept in 159 RA patients was evaluated. The results showed that 52% of patients received concomitant treatment with methotrexate, while 30% received SC abatacept as monotherapy. The findings indicated that patients undergoing SC abatacept treatment experienced improvements in RA disease activity and physical function. Moreover, patients receiving SC abatacept had lower levels of activity and functional impairment at baseline compared to those receiving intravenous administration. The safety profile of SC abatacept was favorable and consistent with previously published data. Additionally, patients with baseline anti-cyclic citrullinated peptide antibody concentrations demonstrated higher treatment survival rates when compared to seronegative patients.

This knowledge can guide clinicians in tailoring individualized treatment regimens based on the specific characteristics and needs of each patient. By utilizing these insights, clinicians can make more informed decisions regarding the use of subcutaneous abatacept and other treatment modalities, ultimately leading to improved disease management and better overall outcomes for RA patients.

References

  1. Alten R, Tony HP, Bannert B, Nüßlein H, Rauch C, Connolly SE, Chartier M, Lozenski K, Hackl R, Forster A, Peichl P. Subcutaneous abatacept for the treatment of rheumatoid arthritis in routine clinical practice in Germany, Austria, and Switzerland: 2-year retention and efficacy by treatment line and serostatus. Clinical Rheumatology. 2023 Jun 14:1-4.
  2. Sarmiento-Monroy JC, Parada-Arias L, Rodríguez-López M, Rodríguez-Jiménez M, Molano-González N, Rojas-Villarraga A, Mantilla RD. Subcutaneous abatacept in rheumatoid arthritis: A real-life experience. Journal of Translational Autoimmunity. 2019 Dec 1;2:100016.
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