Combining abatacept and methotrexate for the treatment of rheumatoid arthritis

This study examined the long-term safety and effectiveness of abatacept (Orencia) and whether methotrexate (Trexall) enhances its effect.

Abatacept is a drug used to treat patients with rheumatoid arthritis (RA). It is generally given to patients in whom anti-tumor necrosis factor therapy has failed. RA is caused by the immune system attacking the joints. Abatacept blocks the immune response in order to prevent joint destruction. The long-term effectiveness and safety of abatacept is currently unknown. It’s also unknown whether combining abatacept with methotrexate can enhance the long-term effect of abatacept.

This study aimed to determine whether abatacept is safe and effective in the long-term. This study also aimed to determine whether methotrexate can increase the long-term effect of abatacept.

This study involved 231 RA patients treated with intravenous (i.v.) abatacept. Patients were followed for at least 1 year to determine the safety and effectiveness of abatacept. 48.5% of patients were also taking methotrexate.

The number of patients who had low disease activity increased over time with abatacept use (from 7.3% at the start to 35.5% at 24 weeks and 43.8% at 52 weeks). Patients taking methotrexate in combination with abatacept were 3 times more likely to achieve low disease activity status.

14.8% of patients did not experience any effect and so discontinued treatment. 3.5% of patients experienced side effects which resulted in the discontinuation of treatment. 

This study concluded that abatacept is safe and effective for long-term use in rheumatoid arthritis patients. Combining abatacept with methotrexate enhances the effect of abatacept. 

This study did not obtain X-rays from the joints of patients to determine whether joint destruction ceased to continue over time. In addition, this study only confirms the safety and effectiveness of i.v. abatacept. Additional studies will need to be performed to determine whether subcutaneous (injection underneath skin) administration of abatacept is also safe and effective. 

Consult your physician regarding the risks and benefits of abatacept treatment.