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Rheumatoid arthritis
Short report
Decreased use of glucocorticoids in biological-experienced patients with rheumatoid arthritis who initiated intravenous abatacept: results from the 2-year ACTION study
  1. Rieke Alten1,
  2. Hubert Nüßlein2,
  3. Mauro Galeazzi3,
  4. Hanns-Martin Lorenz4,
  5. Michael T Nurmohamed5,
  6. William G Bensen6,
  7. Gerd R Burmester7,
  8. Hans-Hartmut Peter8,
  9. Karel Pavelka9,
  10. Mélanie Chartier10,
  11. Coralie Poncet11,
  12. Christiane Rauch12,
  13. Yedid Elbez13 and
  14. Manuela Le Bars14
  1. 1Department of Rheumatology, Schlosspark-Klinik, University Medicine, Berlin, Germany
  2. 2Department of Clinical Immunology and Rheumatology, University of Erlangen-Nuremberg, Nuremberg, Germany
  3. 3Department of Rheumatology, University of Siena, Siena, Italy
  4. 4Department of Rheumatology, University Hospital, Heidelberg, Germany
  5. 5Department of Rheumatology, VU University Medical Center/Jan van Breemen Research Institute, Amsterdam, The Netherlands
  6. 6Department of Rheumatology, St Joseph's Hospital and McMaster University, Hamilton, Ontario, Canada
  7. 7Department of Rheumatology and Immunology, Charité-Universitätsmedizin, Berlin, Germany
  8. 8Center for Chronic Immunodeficiency, University Medical Center, Freiburg, Germany
  9. 9Institute of Rheumatology and Clinic of Rheumatology, Charles University, Prague, Czech Republic
  10. 10Department of Real-World Research, Chiltern International, Neuilly, France
  11. 11Department of Biostatistics, DOCS International, Nanterre, France
  12. 12Department of Medical Immunoscience, Bristol-Myers Squibb, Munich, Germany
  13. 13Excelya, Boulogne-Billancourt, France
  14. 14Department of Medical Affairs, Bristol-Myers Squibb, Rueil-Malmaison, France
  1. Correspondence to Professor Rieke Alten; rieke.alten{at}schlosspark-klinik.de

Abstract

Introduction Prolonged glucocorticoid use may increase the risk of adverse safety outcomes, including cardiovascular events. The European League Against Rheumatism and the Canadian Rheumatology Association advise tapering glucocorticoid dose as rapidly as clinically feasible. There is a paucity of published data on RA that adequately describe concomitant treatment patterns.

Methods ACTION (AbataCepT In rOutiNe clinical practice) is a non-interventional cohort study of patients from Europe and Canada that investigated the long-term retention of intravenous abatacept in clinical practice. We assessed concomitant glucocorticoids in patients with established RA who had participated in ACTION and received ≥1 biological agent prior to abatacept initiation.

Results The analysis included 1009 patients. Glucocorticoids were prescribed at abatacept initiation in 734 (72.7%) patients at a median 7.5 mg/day dose (n=692). Of the patients who remained on abatacept at 24 months, 40.7% were able to decrease their dose of glucocorticoids, including 26.9% who decreased their dose from >5 mg/day to ≤5 mg/day.

Conclusion Reduction and/or cessation of glucocorticoid therapy is possible with intravenous abatacept in clinical practice.

  • Rheumatoid Arthritis
  • Corticosteroids
  • DMARDs (biologic)

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/rmdopen-2015-000228

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