Article Text
Abstract
Objective The impact of gender on the response and tolerance to abatacept was assessed in a large prospective cohort during 2 years of follow-up.
Methods From the 1017 patients included in the Orencia and Rheumatoid Arthritis registry, disease activity was assessed at baseline, 6, 12 and 24 months. The relationship between the European League Against Rheumatism (EULAR) response, Disease Activity Score 28 (DAS28) remission, rate of adverse events and gender was explored in multivariate analysis.
Results 990 patients, 79.3%female, with at least one follow-up visit were analysed. At baseline, women had longer disease duration, higher disease activity and more often received antitumour necrosis factor (TNF) drugs. The remission was not different between men and women during the follow-up after adjustment on age, disease duration and activity, rheumatoid factor and anti-cyclic citrullinated pyeptide (CCP) positivity, and current disease-modifying antirheumatic drugs (DMARDs), previous TNF blockers and corticosteroids use. The proportion of men and women achieving EULAR good-or-moderate response at any endpoints was similar (52.4% vs 55.5%), as well as time to achieving EULAR response (5.4±4.9 vs 5.6±5.2 months). Moderate EULAR response was more frequent in women at 6 months (OR=1.80, p=0.02) but was no longer significant at 12 or 24 months. During the follow-up, the DAS28, the tender joint count score and the patient global assessment remained higher in women (p=0.001, 0.04 and 0.06, respectively). Drug retention and safety were comparable.
Conclusion In this large daily practice cohort of established rheumatoid arthritis treated with abatacept, women achieved similar remission and EULAR response than men despite higher disease activity and tender joint count during the treatment course.
- rheumatoid arthritis
- dmards (biologic)
- treatment
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Footnotes
Funding No specific funding was received from any funding bodies in the public, commercial or not-for-profit sectors to carry out the work described in this manuscript.
Competing interests None declared.
Patient consent Obtained.
Ethics approval The registry was approved by the French authorities (’Comité Consultatif sur le Traitement de l’information en matière de Recherche dans le domaine de la Santé' (CCTIRS) and ’Commission Nationale de l’Informatique et des Libertés' (CNIL)). The ethical committees of all participating centres approved the ORA registry.
Provenance and peer review Not commissioned; externally peer reviewed.