Predictors of the effectiveness of first-line CTLA4-Ig in patients with RA: the FIRST registry
Authors' conclusion
Bio-naive RA patients with low HAQ-DI scores showed high treatment efficacy with no significant difference between CTLA4-Ig and TNFi. Among patients with high baseline HAQ-DI scores, TNFi and CTLA4-Ig were more likely to be effective in those with lower and higher baseline ACPA levels, respectively.
Study context
- Population
- Bio-naïve patients with RA receiving their first bDMARD, July 2013 to August 2022 (FIRST registry)
- Participants
- 953 patients
- Exposure
- First-line CTLA4-Ig vs TNFi in bio-naïve RA
- CTLA4-Ign = 328
- TNFin = 625reference
- Outcome
- CDAI remission rate, adjusted using propensity score (PS)-based inverse probability of treatment weighting (IPTW)
- Follow-up
- Week 24
Methodological detailspropensity score-based inverse probability of treatment weighting, multivariable logistic regression
- Propensity score-based inverse probability of treatment weighting
- Multivariable logistic regression
Main finding
As reported in the abstract
- CTLA4-Ig vs TNFi: P = 0.464
Observational data: associations, not effects.
Further findings
CDAI remission, high baseline HAQ-DI and low baseline ACPA (≦57.2) (subgroup) · week 24
P < 0.0001
CDAI remission, high baseline HAQ-DI and ACPA (>57.2) (subgroup) · week 24
P = 0.0057
Predictors of Clinical Disease Activity Index (CDAI) remission (multivariable logistic regression) · week 24
- Low baseline HAQ-DI scores contributed to CDAI remission in both groups
- High baseline ACPA levels contributed to CDAI remission in the CTLA4-Ig group
Original publication
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