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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<>

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.

Citation: The Pharmaceutical Journal URI: 10001680

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