Objective  To retrospectively analyze the efficacy and safety of abatacept (ABA) in anti citrullinated peptide antibody (ACPA) positive rheumatoid arthritis (RA).

Methods  Clinical data from ACPA positive RA patients who visited the Department of Rheumatology and Immunology at the Second Hospital of Hebei Medical University from May 2020 to January 2023 and were treated with ABA were retrospectively collected and analyzed, to evaluate the efficacy and safety of ABA at 12 weeks and 24 weeks of treatment. Efficacy evaluation measures included RA disease activity score-28 (DAS-28), clinical disease activity index (CDAI), and remission criteria of RA of American College of Rheumatology (ACR).

Results  A total of 35 ACPA-positive RA patients were included in the final analysis. The DAS-28, CDAI, ACR20, ACR50, and ACR70 remission rates at 12 weeks after treatment were 34.29%, 31.43%, 60.00%, 28.57%, and 14.29%, respectively; the DAS-28, CDAI, ACR20, ACR50, and ACR70 remission rates at 24 weeks after treatment were 74.29%, 82.86%, 85.71%, 54.29%, and 31.43%, respectively; in addition, the remission rate at 24 weeks was significantly higher than that at 12 weeks (P﹤0.05). Among the 35 patients included in the analysis, 4 patients experienced respiratory tract infections, 3 patients experienced transient creatinine elevation, and 4 patients experienced elevated blood uric acid.

Conclusion  In the real world, ABA's clinical remission rate is consistent with expectations, and clinical combination drug regimens are flexible and diverse, with high drug safety.

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