Abatacept continues to show benefits for rheumatoid arthritis
Positive results continue to emerge for abatacept, the first in a new class of drugs for rheumatoid arthritis that selectively modulates the co-stimulatory signal required for full T-cell activation. A study published in the Annals
of Internal Medicine last month (2006;144:865) suggests that abatacept reduces disease activity in patients with rheumatoid arthritis who have had an inadequate response to methotrexate.
US researchers randomised 652 patients with active RA despite methotrexate
treatment to receive a once-monthly infusion of abatacept 10mg/kg or
placebo for one year. The primary outcome measure was a 20 per cent improvement
in American College of Rheumatology (ACR) response criteria.
At six months, an ACR20 response was achieved by more patients treated
with abatacept than with placebo (67.9 per cent versus 39.7 per cent;
P<0.001). At 12 months, ACR20 was achieved by 73.1 per cent of patients
in the abatacept group and 39.7 per cent of patients in the placebo group
(P<0.001).
Physical function, health-related quality of life and disease activity
all improved with abatacept, say the researchers. Abatacept also slowed
progression of structural damage by approximately 50 per cent compared
with placebo. However, the incidence of serious infection and infusion
reactions was greater in the abatacept group.
The results from a long-term extension arm of the study were presented
at the Annual European Congress of Rheumatology in Amsterdam last month.
After completing the one-year double-blind phase of the study, 539 patients
entered an abatacept extension arm. Data show that two years of abatacept
slowed progression of structural damage significantly more than one year
of treatment.
Abatacept and TNF inhibitor
therapy Further data presented
at the congress confirmed that the benefits of abatacept, seen at six
months in RA patients
with an inadequate
response to tumour necrosis factor inhibitors (PJ, 8 October 2005, p436),
are
sustained for 18 months. In 317 patients taking conventional disease-modifying
antirheumatic drugs but with an inadequate response to TNF inhibitor therapy,
continued abatacept therapy resulted in improvements in quality of life scores
and physical function, and reductions in disease activity. |
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