Predictors of achieving clinical remission in ACPA-positive RA-patients treated with abatacept and methotrexate and methotrexate monotherapy: a post-hoc analysis of the AVERT and AVERT-II trials
Authors' conclusion
Disease activity at disease presentation and early DAS response were the only consistent predictors for achieving clinical remission. Genetic, imaging and serology parameters did not improve model performance.
Study context
- Population
- ACPA-positive early RA patients; external validation (MTX monotherapy) in the observational Leiden Early Arthritis Clinic (EAC) cohort
- Participants
- 388 vs 743
- Comparison
- Prediction of DAS28-CRP remission on MTX monotherapy and on abatacept + MTX
- Methotrexate-monotherapyn = 388
- Abatacept + methotrexaten = 743
- Primary endpoint
- DAS28-CRP remission
- Follow-up
- 6 and 12 months
Methodological detailspost-hoc analysis, prediction models (logistic regression), external validation in the Leiden EAC cohort
- Post-hoc analysis
- Prediction models (logistic regression)
- External validation in the Leiden EAC cohort
Primary result
As reported in the abstract
DAS28-remission
| Group | Value | Remission at 12 months | Optimism-adjusted AUROC 6/12 months |
|---|---|---|---|
| Methotrexate-monotherapy | 27% | 39% | 0.66/0.65 |
| Abatacept + methotrexate | 43% | 53% | 0.68/0.59 |
Value
Methotrexate-monotherapy27%
Abatacept + methotrexate43%
Remission at 12 months
Methotrexate-monotherapy39%
Abatacept + methotrexate53%
Optimism-adjusted AUROC 6/12 months
Methotrexate-monotherapy0.66/0.65
Abatacept + methotrexate0.68/0.59
Further findings
External validation (Leiden EAC cohort)
- Model performance was very similar
Original publication
Predictors of achieving clinical remission in ACPA-positive RA-patients treated with abatacept and methotrexate and methotrexate monotherapy: a post-hoc analysis of the AVERT and AVERT-II trials. Semin Arthritis Rheum. Published 12 January 2026. doi:10.
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