ABATACEPT CORRELATES WITH LOWER CARE UTILIZATION IN PATIENTS WITH COMMON VARIABLE AND COMMON IMMUNE DEFICIENCIES

• Published in: Annals of allergy, asthma, & immunology Vol. 133; no. 6; p. S65
• Main Authors: Jogdand, A., Hong, J., Pak, A., Digiacomo, D., Barmettler, S., Farmer, J.
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01.11.2024
• ISSN: 1081-1206
• DOI: 10.1016/j.anai.2024.08.216

Primary immune deficiency (PID) patients with autoinflammatory disease have higher morbidity/mortality, yet we lack FDA-approved therapies for care. We investigated clinical use of abatacept and associated outcomes among PID patients. We performed a retrospective review of patients with International Classification of Diseases (ICD)-10 coded diagnoses of common variable immunodeficiency (CVID, D83*) and/or combined immunodeficiency (CID, D81.*) at two separate tertiary care centers. We analyzed the association of abatacept therapy with care utilization (defined as unique hospital admissions), comparing timepoints pre- to post-abatacept therapy by paired t-test (p<0.05). We identified 44 unique patients with CVID/CID who received abatacept at any timepoint. This cohort was predominantly female (84%), non-Hispanic (91%), White (95%), and without identified CTLA4, LRBA, or DEF6 mutations (84%). The primary indications for abatacept use were inflammatory arthritis (55%) and autoimmune enteropathy (AIE, 25%). The median abatacept dose was 625 mg monthly (intravenous, 67%), with a median duration of treatment of 18 (IQR: 4.5-48) months. Care utilization was high in the cohort overall (median 4 (IQR: 2-12) total hospital admissions), with most admissions occurring in the AIE subgroup in the two-year period closely preceding abatacept start. In CVID/CID patients with AIE, abatacept therapy was associated with fewer hospital admissions in the 2-year post-initiation period (median 2; IQR:0-3) compared to the two-year pre-abatacept period (median 3; IQR: 1-7), p=0.03. Abatacept may improve care utilization in CVID/CID patients with AIE. Future work will investigate the impact of abatacept on global autoinflammatory disease score in CVID/CID patients.