Comparative Effectiveness of Abatacept Versus Adalimumab in Shared Epitope Positive and Negative Patients With Rheumatoid Arthritis
Authors' conclusion
We found no evidence that HLA typing is clinically useful to support prescription decisions for these two drugs.
Study context
- Population
- Patients with RA starting abatacept or adalimumab, 53 centres across the UK (BRAGGSS)
- Participants
- 342 patients
- Exposure
- Abatacept vs adalimumab in SE positive and negative patients
- Outcome
- Differential effectiveness between drugs by number of copies of SE or Val11 (interaction term) for response to treatment (EULAR response; DAS28 remission; change in DAS28)
- Follow-up
- 12 months
Methodological detailsnationwide, multicentre (53 centres), observational, 12-month prospective follow-up, Serum abatacept, adalimumab and MTX levels measured at multiple time points; multivariate modelling with demographic, clinical and pharmacological variables
- Nationwide
- Multicentre (53 centres)
- Observational
- 12-month prospective follow-up
- Serum abatacept, adalimumab and MTX levels measured at multiple time points; multivariate modelling with demographic, clinical and pharmacological variables
Main finding
As reported in the abstract
Differential effectiveness of abatacept vs adalimumab by SE/Val11
- No significant difference between drugs in the effect of genetic markers on response
Observational data: associations, not effects.
Further findings
Efficacy of abatacept vs adalimumab
- No difference in efficacy of abatacept vs adalimumab
Independent association of Val11 with EULAR response
- Weak evidence for independent association of Val11 with EULAR response
- P = 0.02
Original publication
Comparative Effectiveness of Abatacept Versus Adalimumab in Shared Epitope Positive and Negative Patients With Rheumatoid Arthritis. Arthritis Rheumatol. Published 23 September 2025. doi:10.
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