Background Abatacept is a biologic disease modifying antirheumatic drug (DMARD) prescribed to rheumatoid arthritis (RA) patients who have shown insufficient response to conventional synthetic DMARD. Abatacept modulates T cell function by selectively targeting the CD80/CD86:CD28 signal required for full T cell activation.

Purpose The aim was to evaluate the drug continuation rate of abatacept in RA patients in real clinical practice, and to identify the reasons for drug discontinuation and the new biotherapy initiated.

Material and methods This study was conducing in a university hospital and included all patients with RA who received at least one injection of abatacept between 1 January 2007 and 31 October 2012. Drug continuation rate was estimated in RA patients by plotting Kaplan–Meier curves. The end point of the follow-up period was 31 December 2015. The following characteristics were collected: age, sex, date of diagnosis, previous treatment, concomitant treatment with abatacept, date of first and last drug injection, motives for abatacept failure and the new initiated biotherapy. Periods with no treatment for more than 3 month were studied.

Results 53 patients were included in the study. Most patients were women (70%) with a mean age of 56±12 years (24–82) and mean disease duration of 15±10 years. Most of the patients had previously been treated with methotrexate (96%) and only 4% had never had biotherapy. Etanercept and adalimumab were the most common biotherapies. Concomitant MTX at baseline was given to 49%. Drug continuation rates at 6, 12, 18, 24, 36 and 48 months were, respectively, 77%, 74%, 68%, 60%, 49%, 43%. Abatacept was stopped because of inefficiency (27%) or therapeutic escape (40%). Following discontinuation of abatacept, 56% of treatments were switched to tocilizumab and 20% were switched to rituximab. Treatment of 12 patients (23%) was suspended for at least 3 months.

Conclusion Over a study period of more than 8 years, drug continuation rates of abatacept seemed to be similar to those found in studies published on this subject. Also, thanks to the safety profile of abatacept, it appears to be a good therapeutic option in rheumatoid arthritis.

References and/or acknowledgements Nüßlein HG. BMC Musculoskelet Disord2015;16:176.

Leffers HC. Ann Rheum Dis. 2011;70:1216–22.

Schiff M. Int J Clin Rheumatol2010;5:581–91.

Hirabara. Clin Rheumatol2014;33:1247–54.

No conflict of interest