Body mass index and treatment response to subcutaneous abatacept in patients with psoriatic arthritis: a post hoc analysis of a phase III trial

Objective This post hoc analysis of the phase III Active PSoriaTic Arthritis RAndomizEd TriAl (ASTRAEA) evaluated the effect of baseline body mass index (BMI) on subsequent response to subcutaneous (SC) abatacept in patients with psoriatic arthritis (PsA).Methods In ASTRAEA, patients with active PsA...

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Main Authors: Philip J Mease, Iain B McInnes, Gianfranco Ferraccioli, Maria-Antonietta D'Agostino, Manuela Le Bars, Subhashis Banerjee, Harris A Ahmad, Yedid Elbez
Format: Article
Language:English
Published: BMJ Publishing Group 2019-06-01
Series:RMD Open
Online Access:https://rmdopen.bmj.com/content/5/1/e000934.full
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author Philip J Mease
Iain B McInnes
Gianfranco Ferraccioli
Maria-Antonietta D'Agostino
Manuela Le Bars
Subhashis Banerjee
Harris A Ahmad
Yedid Elbez
author_facet Philip J Mease
Iain B McInnes
Gianfranco Ferraccioli
Maria-Antonietta D'Agostino
Manuela Le Bars
Subhashis Banerjee
Harris A Ahmad
Yedid Elbez
author_sort Philip J Mease
collection DOAJ
description Objective This post hoc analysis of the phase III Active PSoriaTic Arthritis RAndomizEd TriAl (ASTRAEA) evaluated the effect of baseline body mass index (BMI) on subsequent response to subcutaneous (SC) abatacept in patients with psoriatic arthritis (PsA).Methods In ASTRAEA, patients with active PsA were randomised (1:1) to receive blinded weekly SC abatacept 125 mg or placebo for 24 weeks. Treatment response at week 24 was assessed by the proportions of patients achieving American College of Rheumatology 20% improvement response, Disease Activity Score in 28 joints (DAS28 (C reactive protein (CRP))) ≤3.6 and <2.6, Health Assessment Questionnaire-Disability Index reduction from baseline ≥0.35 and radiographic non-progression (defined as change from baseline ≤0 in PsA-modified total Sharp/van der Heijde score). Responses were stratified by baseline BMI (underweight/normal, <25 kg/m2; overweight, 25–30 kg/m2; obese, >30 kg/m2) and compared in univariate and multivariate models.Results Of 212/213 and 210/211 patients with baseline BMI data in the abatacept and placebo groups, respectively, 15% and 19% were underweight/normal, 36% and 27% were overweight, and 49% and 54% were obese. After adjusting for baseline characteristics, there were no significant differences for any outcome measure at week 24 with abatacept in the overweight or obese versus underweight/normal subgroup. In the placebo group, patients in the obese versus underweight/normal subgroup were significantly less likely to achieve DAS28 (CRP) <2.6 at week 24 (OR 0.26; 95% CI 0.08 to 0.87; p=0.03).Conclusion BMI does not impact clinical or radiographic response to SC abatacept in patients with PsA.Trial registration number NCT01860976.
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spelling doaj-art-69a3fb4c228142e5a9be23c0e20a64972025-08-20T03:25:23ZengBMJ Publishing GroupRMD Open2056-59332019-06-015110.1136/rmdopen-2019-000934Body mass index and treatment response to subcutaneous abatacept in patients with psoriatic arthritis: a post hoc analysis of a phase III trialPhilip J Mease0Iain B McInnes1Gianfranco Ferraccioli2Maria-Antonietta D'Agostino3Manuela Le Bars4Subhashis Banerjee5Harris A Ahmad6Yedid Elbez74 Swedish Medical Center and University of Washington, Seattle, Washington, USA3 College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UKDivision of Rheumatology, IRCCS—Fondazione Policlinico Universitario A. Gemelli—Catholic University of the Sacred Heart, Rome, ItalyRheumatology, Université Versailles Saint-Quentin en Yvelines, Ambroise Paré Hospital, APHP, Boulogne-Billancourt, FranceBristol-Myers Squibb, Rueil-Malmaison, FranceBristol Myers Squibb Co, Princeton, New Jersey, USABristol-Myers Squibb, Princeton, New Jersey, USAExcelya, Boulogne-Billancourt, FranceObjective This post hoc analysis of the phase III Active PSoriaTic Arthritis RAndomizEd TriAl (ASTRAEA) evaluated the effect of baseline body mass index (BMI) on subsequent response to subcutaneous (SC) abatacept in patients with psoriatic arthritis (PsA).Methods In ASTRAEA, patients with active PsA were randomised (1:1) to receive blinded weekly SC abatacept 125 mg or placebo for 24 weeks. Treatment response at week 24 was assessed by the proportions of patients achieving American College of Rheumatology 20% improvement response, Disease Activity Score in 28 joints (DAS28 (C reactive protein (CRP))) ≤3.6 and <2.6, Health Assessment Questionnaire-Disability Index reduction from baseline ≥0.35 and radiographic non-progression (defined as change from baseline ≤0 in PsA-modified total Sharp/van der Heijde score). Responses were stratified by baseline BMI (underweight/normal, <25 kg/m2; overweight, 25–30 kg/m2; obese, >30 kg/m2) and compared in univariate and multivariate models.Results Of 212/213 and 210/211 patients with baseline BMI data in the abatacept and placebo groups, respectively, 15% and 19% were underweight/normal, 36% and 27% were overweight, and 49% and 54% were obese. After adjusting for baseline characteristics, there were no significant differences for any outcome measure at week 24 with abatacept in the overweight or obese versus underweight/normal subgroup. In the placebo group, patients in the obese versus underweight/normal subgroup were significantly less likely to achieve DAS28 (CRP) <2.6 at week 24 (OR 0.26; 95% CI 0.08 to 0.87; p=0.03).Conclusion BMI does not impact clinical or radiographic response to SC abatacept in patients with PsA.Trial registration number NCT01860976.https://rmdopen.bmj.com/content/5/1/e000934.full
spellingShingle Philip J Mease
Iain B McInnes
Gianfranco Ferraccioli
Maria-Antonietta D'Agostino
Manuela Le Bars
Subhashis Banerjee
Harris A Ahmad
Yedid Elbez
Body mass index and treatment response to subcutaneous abatacept in patients with psoriatic arthritis: a post hoc analysis of a phase III trial
RMD Open
title Body mass index and treatment response to subcutaneous abatacept in patients with psoriatic arthritis: a post hoc analysis of a phase III trial
title_full Body mass index and treatment response to subcutaneous abatacept in patients with psoriatic arthritis: a post hoc analysis of a phase III trial
title_fullStr Body mass index and treatment response to subcutaneous abatacept in patients with psoriatic arthritis: a post hoc analysis of a phase III trial
title_full_unstemmed Body mass index and treatment response to subcutaneous abatacept in patients with psoriatic arthritis: a post hoc analysis of a phase III trial
title_short Body mass index and treatment response to subcutaneous abatacept in patients with psoriatic arthritis: a post hoc analysis of a phase III trial
title_sort body mass index and treatment response to subcutaneous abatacept in patients with psoriatic arthritis a post hoc analysis of a phase iii trial
url https://rmdopen.bmj.com/content/5/1/e000934.full
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