Long‐Term Maintenance of Clinical Responses by Individual Patients With Polyarticular‐Course Juvenile Idiopathic Arthritis Treated With Abatacept

Abstract

ObjectiveTo investigate the frequency and trajectories of individual patients with polyarticular‐course juvenile idiopathic arthritis (JIA) achieving novel composite end points on abatacept.MethodsData from a clinical trial of subcutaneous abatacept (NCT01844518) and a post hoc analysis of intravenous abatacept (NCT00095173) in patients with polyarticular‐course JIA were included. Three end points were defined and evaluated: combined occurrence of low disease activity (LDA) measured by the Juvenile Arthritis Disease Activity Score; 50% improvement in American College of Rheumatology criteria for JIA (ACR50); and patient‐reported outcomes. Patient‐reported outcomes included visual analog scale score of minimal pain (pain‐min) and Childhood Health Assessment Questionnaire disability index score of 0 (C‐HAQ DI0). In this post hoc analysis, maintenance of month 13 and 21 end points (LDA+pain‐min, LDA+C‐HAQ DI0, and ACR50+pain‐min) in those who achieved them at month 4 was determined.ResultsComposite end points (LDA+pain‐min, LDA+C‐HAQ DI0, and ACR50+pain‐min) were achieved at month 4 (44.7%, 19.6%, and 58.9% of the 219 patients treated with subcutaneous abatacept, respectively). Of those who achieved LDA+pain‐min at month 4, 84.7% (83 of 98) and 65.3% (64 of 98) maintained LDA+pain‐min at months 13 and 21, respectively. The proportions of patients meeting LDA+pain‐min outcomes increased from 44.7% (98 of 219) at month 4 to 54.8% (120 of 219) at month 21. The frequency of patients who met an LDA+C‐HAQ DI score of 0 increased from 19.6% (43 of 219) at month 4 to 28.8% (63 of 219) at month 21.ConclusionAmong individual patients with polyarticular‐course JIA treated with abatacept who achieved 1 of the combined clinical and patient‐reported outcomes composite end points, many maintained them over 21 months of abatacept treatment.