| Autor: |
Ogawa N; a Division of Immunology and Rheumatology, Department of Internal Medicine 3 , Hamamatsu University School of Medicine , Hamamatsu-City , Japan., Ohashi H; b Department of Rheumatology, Omaezaki Municipal Hospital , Omaezaki-City , Japan., Ota Y; c Yasuhiro Clinic , Hamamatsu-City , Japan., Kobori K; d Kobori Orthopedic Clinic , Hamamatsu-City , Japan., Suzuki M; e Department of Orthopedic Surgery , Hamamatsu University School of Medicine , Hamamatsu , Japan., Tsuboi S; f Department of Rheumatology, Shizuoka Kosei Hospital , Shizuoka-City , Japan., Hayakawa M; g Hayakawa Clinic , Hamamatsu , Japan., Goto Y; h Goto Clinic , Hamamatsu , Japan., Karahashi T; i Department of Rheumatology, Fujieda Municipal Hospital , Fujieda , Japan., Kimoto O; j Kimoto Clinic , Hamamatsu , Japan., Miyamoto T; k Department of Rheumatology, Seirei Hamamatsu General Hospital , Hamamatsu , Japan., Furukawa S; a Division of Immunology and Rheumatology, Department of Internal Medicine 3 , Hamamatsu University School of Medicine , Hamamatsu-City , Japan., Shimoyama K; a Division of Immunology and Rheumatology, Department of Internal Medicine 3 , Hamamatsu University School of Medicine , Hamamatsu-City , Japan., Suzuki D; a Division of Immunology and Rheumatology, Department of Internal Medicine 3 , Hamamatsu University School of Medicine , Hamamatsu-City , Japan., Maekawa Y; a Division of Immunology and Rheumatology, Department of Internal Medicine 3 , Hamamatsu University School of Medicine , Hamamatsu-City , Japan. |
| Abstrakt: |
The aim of this study was to assess abatacept in rheumatoid arthritis (RA) patient. Patients (20 men, 89 women, aged 61.9 ± 10.4 y) who responded inadequately to conventional synthetic disease-modifying anti-rheumatic drug were treated with abatacept for 24-months. Disease activity score in 28 joints (DAS28-CRP) was evaluated. Of 109 patients, 82 (75.2%) were on methotrexate (MTX; mean dosage 9.0 ± 2.7 mg/week); 48 (44.0%) were naive to biologics and 61 (56.0%) had failed biologics. The 1- and 2-year retention rates were 77% and 53%, respectively. At 24-months, the DAS28-CRP remission rates were 54.5% in the biologic-naïve patients, and 28.2% in the biologic-failure patients ( p < .01), while the structural remission rates were 83.9% and 73.1%, respectively ( p = .461). Abatacept was equally effective in RA patients who were and were not on concomitant MTX. Biologic-naïve was associated with better clinical outcome. Abatacept was effective in patients who showed decreasing anti-CCP antibody titers or serum MMP-3 levels during treatment. Infection was the most frequent adverse effect of abatacept therapy. In conclusion, abatacept is more effective in biologic-naïve than in biologic-failure RA patients with or without concomitant use of MTX. Abatacept is more effective in RA patients with than without decreasing serum MMP-3 or anti-CCP antibody titers during treatment. |
