Abatacept exposure does not increase infection risk in pJIA patients

Higher exposure levels to intravenous (IV) or subcutaneous (SC) abatacept (ABA) among patients with polyarticular-course juvenile idiopathic arthritis (pJIA) aged 2–17 years is not associated with incidence of infection, a study has shown.

To assess the interaction between infection risk and ABA exposure levels, the investigators analysed data from two published studies (ClinicalTrials.gov: NCT01844518, NCT00095173) of ABA treatment in paediatric patients. One study treated patients aged 2–17 years with SC ABA, while the other treated patients aged 6–17 years with IV ABA.

Kaplan-Meier plots of probability of first infection compared with time on treated by ABA exposure quartiles and log-rank tests were used to assess the relationship between serum ABA exposure measures and infection. Finally, the proportion of infections by ABA exposure quartiles was examined.

A total of 343 patients were included in the analysis, of which 219 received SC ABA and 124 IV ABA. Some 237 patients (69.1 percent) had at least one infection over 24 months. There was no significant difference in time to first infection across quartiles of ABA exposure levels noted in the pooled (p=0.45), SC (2–5 years: p=0.93; 6–17 years: p=0.48), or IV (p=0.50) analyses.

Furthermore, concomitant use of methotrexate and glucocorticoids (at baseline and throughout) with ABA did not lead to an increase in risk of infection across the ABA exposure quartiles. No evidence of association between number of infections and ABA exposure quartiles was found. In addition, no opportunistic infections associated with ABA occurred.