Long-term results of joint damage in patients with rheumatoid arthritis treated with abatacept: 5-year results of a clinical observational study
Background: In abatacept treatment for RA, there are no studies investigating the long-term results of joint damage in daily clinical practice. We aimed to investigate the long-term efficacy of abatacept in Japanese patients with rheumatoid arthritis. Methods: We examined 120 patients who received abatacept for 5 years. Joint damage was radiographically analyzed using the van der Heijde-modified total Sharp score. Disease activity score was assessed using the disease activity score in 28 joints-erythrocyte sedimentation rate (DAS28-ESR). The data analyses were used by observed case analysis. Results: Changes in the Sharp score was 0.60 ± 2.03, 0.93 ± 2.40, 1.23 ± 2.92, 1.53 ± 3.38, and 1.71 ± 3.84 at years 1, 2, 3, 4, and 5, respectively. Progression of joint damage did not differ significantly between the Bio-naÃ¯ve and Bio-switch groups and methotrexate [MTX](+) and MTX(MTX(-)) groups. DAS28-ESR at baseline was associated with radiographic progression (p = 0.035). In all patients, the remission rates of DAS28-ESR were 44.6% and 50.0% at years 1 and 5, respectively. These rates were 45.2% and 50.8% in the biological disease-modifying anti-rheumatic drugs (Bio)-naïve¯ve group, and 42.9% and 47.1% in the Bio-switch group, respectively. Moreover, these rates were 45.2% and 52.6% in the MTX(+) group and 43.6% and 47.6% in the MTX(-) group, respectively. The remission rates were not significantly different between the groups at any of time points. Conclusions: we have analyzed the efficacy of abatacept treatment in patient with RA for 5 years in daily clinical practice. The present study suggested that improvement of joint damage, disease activity, and physical function are maintained in the long-term.