AB0543 Remission using different composite disease indices in MTX-IR RA patients treated with abatacept or infliximab, +MTX. (23rd January 2014)

• Record Type: Journal Article
• Authors: Smolen, J.; Dougados, M.; Gaillez, C.; Poncet, C.; Le Bars, M.; Elegbe, A.; Schiff, M.
• Is Part Of: Annals of the rheumatic diseases. Volume 71(2012)Supplement 3
• Page Start: 669
• Page End: 669
• Publication Date: 2014-01-23
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2012-eular.543
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Background: Levels of acute-phase reactants, which correlate with clinical disease activity in RA, 1 are differentially weighted in the calculation of disease activity indices such as DAS28/SDAI. Acute-phase reactants and disease activity measures may be affected differently by biologics with different mechanisms of action. 2 Objectives: To evaluate remission using the ACR/EULAR index-based definition of remission 3 vs DAS28-defined remission in biologic-naïve MTX-IR RA patients (pts) from AIM 4 and ATTEST 5 trials, and assess the contribution of core components. Methods: In AIM, pts were randomized to abatacept (ABA; ∼10 mg/kg every 4 wks) or PBO, plus MTX. 4 In ATTEST, pts were randomized to ABA (∼10 mg/kg every 4 wks), IFX (3 mg/kg every 8 wks), or PBO (every 4 wks), plus MTX. 5 Post-hoc analyses evaluated remission according to DAS28(CRP) and SDAI at 6 mths; missing data were imputed by LOCF. Results: Baseline demographics and disease characteristics were similar between groups in each trial. 4, 5 All pts achieving DAS28 remission at 6 mths were either in SDAI remission or SDAI LDAS. At 6 mths, for pts achieving SDAI remission, core components were generally similar and≤1. Conclusions: In ATTEST, remission rates at 6 mths were similar for abatacept and IFX independent of the composite measure. When using SDAI remission criteria to assess remission, core components of abatacept-treated pts were consistent in AIM and ATTEST and similar to that of IFX-treated pts and ≤1, suggesting no residual disease activity in contrast with DAS28 remission criteria. This confirms that SDAI is a more accurate composite index than DAS28-CRP in assessing true remission. References: Mallya RK et al. J Rheumatol 1982;9:224–8; Smolen JS, Aletaha D. Arthritis Rheum 2011;63:43–52; Felson DT et al. Ann Rheum Dis 2011;70:404–13. Kremer JM et al. Ann Int Med 2006;144:865–76; Schiff M et al. Ann Rheum Dis 2008;67:1096–103. Disclosure of Interest: J. Smolen Grant/Research support from: Abbott Laboratories, Bristol-Myers Squibb, Hoffmann-La Roche, Inc., Schering-Plough, UCB, Inc., Pfizer, Consultant for: Abbott Laboratories, Amgen Inc., AstraZeneca, Bristol-Myers Squibb, Centocor, Inc., Eli Lilly and Company, Merck, Novo Nordisk, Roche, sanofi-aventis, UCB, Inc., M. Dougados Grant/Research support from: Bristol-Myers Squibb, Consultant for: Bristol-Myers Squibb, Speakers Bureau: Bristol-Myers Squibb, C. Gaillez Shareholder of: Bristol-Myers Squibb, Employee of: Bristol-Myers Squibb, C. Poncet: None Declared, M. Le Bars Shareholder of: Bristol-Myers Squibb, Employee of: Bristol-Myers Squibb, A. Elegbe Shareholder of: Bristol-Myers Squibb, Employee of: Bristol-Myers Squibb, M. Schiff Consultant for: Bristol-Myers Squibb