Abatacept Most Effective Early and in Seropositive RA Save

An open-label, 2 year study evaluated the efficacy and safey (drug retention) of subcutaneous (SC) abatacept (ABA) in active rheumatoid arthritis (RA) and showed superior responses when ABA was given to biologic-naive and seropositive RA patients. 

The ASCORE (Abatacept SubCutaneOus in Routine clinical practicE) study examined ABA retention rates (primary endpoint) along with efficacy measures in moderate-severe RA patients. Retention rate by baseline serostatus was evaluated post hoc.

The study involved 2892 RA patients from 10 countries 2892 patients - 41% were biologic-naïve and 59% were biologic experienced. Lack of efficacy (66%) and intolerance/safety (27%) were the most common reasons for prior biologic discontinuation.

ABA retention at 2 years was 47%, with higher rates for those who were biologic naive (52%) compared to those with ≥ 1 prior biologic treatment failure (46%) or those with ≥ 2 prior biologic treatment failures (43%).

Amongst biologic naive patients, patients who were double seropositive had greater retention success (57%) compared to single positive (50%) and double negative patients (37%). In biologic experience patients, seropositivity still confered and advantage, albeit less (48% vs. 42% vs. 40%, respectively).

Adverse events (AE) and serious AE did not differ based on prior biologic exposure. 

Better ABA outcomes can be achieved with earlier use, especially in those who have seropositive RA.