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dc.contributor.authorHarrold, Leslie R
dc.contributor.authorWittstock, Keith
dc.contributor.authorKelly, Sheila
dc.contributor.authorHan, Xue
dc.contributor.authorZhuo, Joe
dc.contributor.authorSchrader, Amy
dc.contributor.authorMiddaugh, Nicole
dc.contributor.authorMoore, Page C
dc.contributor.authorKhaychuk, Vadim
dc.date.accessioned2024-02-07T14:15:57Z
dc.date.available2024-02-07T14:15:57Z
dc.date.issued2024-01-19
dc.identifier.citationHarrold LR, Wittstock K, Kelly S, Han X, Zhuo J, Schrader A, Middaugh N, Moore PC, Khaychuk V. Comparative effectiveness of abatacept versus TNF inhibitors in rheumatoid arthritis patients who are ACPA and shared epitope positive. Adv Rheumatol. 2024 Jan 19;64(1):10. doi: 10.1186/s42358-024-00352-4. PMID: 38243281.en_US
dc.identifier.eissn2523-3106
dc.identifier.doi10.1186/s42358-024-00352-4en_US
dc.identifier.pmid38243281
dc.identifier.urihttp://hdl.handle.net/20.500.14038/53036
dc.description.abstractBackground: The HLA-DRB1 shared epitope (SE) is a risk factor for the development of rheumatoid arthritis (RA) and the production of anti-citrullinated protein antibodies (ACPAs) in RA patients. Our objective was to examine the real-world effectiveness of abatacept versus tumor necrosis factor inhibitors (TNFi) in patients with RA who were SE and anti-cyclic citrullinated peptide antibody (anti-CCP3) positive. Methods: Abatacept or TNFi initiators who were SE + and anti-CCP3+ (> 20 U/mL) at or prior to treatment and had moderate or high CDAI score (> 10) at initiation were identified. The primary outcome was mean change in CDAI score over six months. Analyses were conducted in propensity score (PS)-trimmed and -matched populations overall and a biologic-experienced subgroup. Mixed-effects models were used. Results: In the overall PS-trimmed (abatacept, n = 170; TNFi, n = 157) and PS-matched cohorts (abatacept, n = 111; TNFi, n = 111), there were numerically greater improvements in mean change in CDAI between abatacept and TNFi but were not statistically significant. Similar trends were seen for biologic-experienced patients, except that statistical significance was reached for mean change in CDAI in the PS-trimmed cohort (abatacept, 12.22 [95% confidence interval (95%CI) 10.13 to 14.31]; TNFi, 9.28 [95%CI 7.08 to 11.48]; p = 0.045). Conclusion: In this real world cohort, there were numerical improvements in efficacy outcomes with abatacept over TNFi in patients with RA who were SE + and ACPA+, similar to results from a clinical trial population The only statistically significant finding after adjusting for covariates was greater improvement in CDAI with abatacept versus TNFi in the bio-experienced PS-trimmed cohort..en_US
dc.language.isoenen_US
dc.relation.ispartofAdvances in Rheumatologyen_US
dc.relation.urlhttps://doi.org/10.1186/s42358-024-00352-4en_US
dc.rights© The Author(s) 2024. Open Access: This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.en_US
dc.rightsAttribution 4.0 International*
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/*
dc.subjectAbatacepten_US
dc.subjectEpitopesen_US
dc.subjectRegistriesen_US
dc.subjectRheumatoid arthritisen_US
dc.subjectTNF inhibitorsen_US
dc.titleComparative effectiveness of abatacept versus TNF inhibitors in rheumatoid arthritis patients who are ACPA and shared epitope positiveen_US
dc.typeJournal Articleen_US
dc.source.journaltitleAdvances in rheumatology (London, England)
dc.source.volume64
dc.source.issue1
dc.source.beginpage10
dc.source.endpage
dc.source.countryEngland
dc.identifier.journalAdvances in rheumatology (London, England)
refterms.dateFOA2024-02-07T14:15:59Z
dc.contributor.departmentMedicineen_US


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© The Author(s) 2024. Open Access: This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use,
sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and
the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this
article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included
in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will
need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
Except where otherwise noted, this item's license is described as © The Author(s) 2024. Open Access: This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.