{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T22:52:31Z","timestamp":1770331951587,"version":"3.49.0"},"reference-count":48,"publisher":"Becaris Publishing Limited","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Comp. Eff. Res."],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:p>\n                    <jats:bold>Aim:<\/jats:bold>\n                    To compare characteristics of patients with anticitrullinated protein antibody-positive (ACPA+) and rheumatoid factor-positive (RF+) rheumatoid arthritis (RA) who initiated abatacept or a tumor necrosis factor inhibitor (TNFi) as a first-line biologic disease-modifying antirheumatic drug (bDMARD), and to identify factors associated with first-line bDMARD selection.\n                    <jats:bold>Materials &amp; methods:<\/jats:bold>\n                    This retrospective cohort study abstracted data for patients with ACPA+\/RF+ RA initiating abatacept or a TNFi as a first-line bDMARD between 1 January 2015 and 19 February 2020. Patient characteristics were compared using chi-square\/Fisher exact tests (categorical variables) and Wilcoxon tests (continuous variables). Adjusted odds ratios (OR; 95% confidence interval [CI]) of initiating abatacept versus TNFi were estimated using 2-level logistic regression.\n                    <jats:bold>Results:<\/jats:bold>\n                    The analysis cohort included 301 patients who initiated abatacept and 203 patients who initiated a TNFi. Time from RA diagnosis to first-line initiation (&gt;2\u00a0years vs &lt;1\u00a0year; OR [95% CI] 2.9 [1.4\u20136.1]), high and moderate disease activity (versus low; 5.0 [1.8\u201313.9] and 4.2 [1.5\u201311.6], respectively), and conventional synthetic (cs) DMARD use within 12\u00a0months prior to initiation (versus no csDMARD use; 2.0 [1.1\u20133.6]) were associated with higher odds of initiating abatacept versus a TNFi (all p\u00a0&lt;\u00a00.05). Patients with Medicare\/other insurance had increased odds of initiating abatacept (versus TNFi) as age increased. Baseline ACPA &gt;250 AU\/ml was associated with lower odds of initiating abatacept over a TNFi (versus ACPA 20\u2013250 AU\/ml; 0.4 [0.2\u20130.8]; p\u00a0&lt;\u00a00.01).\n                    <jats:bold>Conclusion:<\/jats:bold>\n                    In this real-world study, patients with ACPA+\/RF+ RA were more likely to initiate abatacept over TNFi as a first-line bDMARD if they had delayed first-line bDMARD initiation, high\/moderate disease activity, prior csDMARD use, or were of an older age. There is a need for better understanding of treatment selection and to account for these variables in future studies.\n                  <\/jats:p>","DOI":"10.57264\/cer-2025-0062","type":"journal-article","created":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T12:12:11Z","timestamp":1769515931000},"source":"Crossref","is-referenced-by-count":0,"title":["First-line tumor necrosis factor inhibitor versus abatacept treatment choice in real-world patients with anticitrullinated protein antibody- and rheumatoid factor-positive rheumatoid arthritis"],"prefix":"10.57264","volume":"15","author":[{"given":"Gordon","family":"Lam","sequence":"first","affiliation":[{"name":"Arthritis &amp; Osteoporosis Consultants of the Carolinas, Atrium Health Wake Forest Baptist, Charlotte, NC 28202, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hanke","family":"Zheng","sequence":"additional","affiliation":[{"name":"Bristol Myers Squibb, Princeton, NJ 08543, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Klink","sequence":"additional","affiliation":[{"name":"Cardinal Health, Dublin, OH 43017, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vardhaman","family":"Patel","sequence":"additional","affiliation":[{"name":"Bristol Myers Squibb, Princeton, NJ 08543, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily","family":"Bland","sequence":"additional","affiliation":[{"name":"Cardinal Health, Dublin, OH 43017, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laetitia","family":"N'Dri","sequence":"additional","affiliation":[{"name":"Bristol Myers Squibb, Princeton, NJ 08543, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Parisa","family":"Asgarisabet","sequence":"additional","affiliation":[{"name":"Cardinal Health, Dublin, OH 43017, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keith","family":"Wittstock","sequence":"additional","affiliation":[{"name":"Bristol Myers Squibb, Princeton, NJ 08543, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cherrishe","family":"Brown-Bickerstaff","sequence":"additional","affiliation":[{"name":"Cardinal Health, Dublin, OH 43017, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Chaballa","sequence":"additional","affiliation":[{"name":"Bristol Myers Squibb, Princeton, NJ 08543, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vadim","family":"Khaychuk","sequence":"additional","affiliation":[{"name":"Bristol Myers Squibb, Princeton, NJ 08543, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruce","family":"Feinberg","sequence":"additional","affiliation":[{"name":"Cardinal Health, Dublin, OH 43017, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"36897","reference":[{"issue":"5","key":"e_1_3_9_3_2","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1007\/s00296-020-04731-0","article-title":"The global prevalence of rheumatoid arthritis: a meta-analysis based on a systematic review","volume":"41","author":"Almutairi K","year":"2021","unstructured":"Almutairi K, Nossent J, Preen D, Keen H, Inderjeeth C. The global prevalence of rheumatoid arthritis: a meta-analysis based on a systematic review. Rheumatol. Int. 41(5), 863\u2013877 (2021).","journal-title":"Rheumatol. Int."},{"issue":"9","key":"e_1_3_9_4_2","doi-asserted-by":"crossref","first-page":"1551","DOI":"10.1007\/s00296-017-3726-1","article-title":"Prevalence of rheumatoid arthritis in the United States adult population in healthcare claims databases, 2004\u20132014","volume":"37","author":"Hunter TM","year":"2017","unstructured":"Hunter TM, Boytsov NN, Zhang X, Schroeder K, Michaud K, Araujo AB. Prevalence of rheumatoid arthritis in the United States adult population in healthcare claims databases, 2004\u20132014. Rheumatol. Int. 37(9), 1551\u20131557 (2017).","journal-title":"Rheumatol. 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