Less Cardiovascular Risk with Abatacept in Rheumatoid Arthritis Save

A claims data analysis shows that abatacept use in rheumatoid arthritis (RA) patients yielded a modestly reduced cardiovascular risk when compared to patients receiving TNF inhibitors (TNFi).

Using claims data from Medicare and MarketScan, researchers from Harvard assessed the frequency of cardiovascular (CV) outcomes in RA patients receiving either ABA or TNFi.  The primary outcome was a composite cardiovascular end point of myocardial infarction (MI), stroke/transient ischemic attack, and coronary revascularization.

The study included 13 039 PS‐matched patients on either abatacept (ABA) or TNFi.  Background diabetes (DM) was found 34.7% of Medicare and 19.8% of MarketScan patients.

CV events were less frequent with abatacept use versus TNF inhibitor; the HR was 0.81 (0.66–0.99) in Medicare and 0.95 (0.74–1.23) in MarketScan, with a pooled HR of 0.86 (95% CI, 0.73–1.01; P=0.3 for heterogeneity).

While those with diabetes had an even lower CV event rate for ABA vs. TNFi (HR 0.74; 95%CI 0.57–0.96; P=0.7) for heterogeneity), the same was not seen in those without diabetes  (pooled HR 0.94; 95% CI, 0.77–1.14; P=0.4).

In RA patients, ABA was be associated with a modest reduction in cardiovascular risk (compared with TNFi), particularly in patients with DM.