In a nutshell
This study investigated the safety and effectiveness of abatacept (Orencia) in combination with other medications to treat rheumatoid arthritis. The study concluded that abatacept in combination with conventional synthetic DMARDs was well tolerated and similarly effective as abatacept and methotrexate.
Some background
Rheumatoid arthritis (RA) is a condition that causes painful inflammation and swelling in the joints. Patients are treated with disease-modifying anti-rheumatic drugs (DMARDs). These medications reduce inflammation.
Methotrexate (MTX) is a DMARD and the first line of treatment for patients diagnosed with RA. However, how MTX works to reduce inflammation is unclear and some patients do not respond well to it. In these cases, patients will be prescribed other DMARDs in combination with MTX. Current recommendations are to prescribe a synthetic (cs)DMARD in addition to MTX to improve treatment response.
Some patients cannot take MTX due to other conditions (e.g. liver and kidney disease). These patients often try csDMARDs instead. Abatacept is a DMARD that prevents the activation of T cells that cause inflammation. It is commonly prescribed in combination with MTX to improve symptoms. Less is known about the effects of abatacept in combination with other csDMARDs.
Methods & findings
This study investigated the effects of abatacept in combination with csDMARDs in patients with moderate-to-severe arthritis.
This study included data from 4 clinical trials including 3,113 patients. Patients in these studies were undergoing treatment with abatacept in combination with csDMARDs or MTX. The csDMARDs prescribed included hydroxychloroquine, sulfasalazine, azathioprine, or leflunomide. Treatment and observation lasted between 6 months and 2 years. Physical function was measured using a number of standard assessments of disease activity. Safety data was also obtained to determine the risks associated with abatacept treatment.
Abatacept treatment in combination with MTX had similar disease activity response rates compared to combined abatacept and csDMARD treatment. The number of adverse events (side effects) was similar between patients taking MTX versus csDMARDs in combination with abatacept. The most common side effects were infections and skin tissue disorders.
The bottom line
The authors concluded that abatacept in combination with csDMARDs was well tolerated and similarly effective as abatacept and MTX.
The fine print
This study analysed results from clinical trials with different designs. As a result it is difficult to compare the data. A large study looking specifically at the safety of abatacept in combination with other medications is needed to confirm these findings.
What’s next?
Please consult with your physician if you have any concerns regarding medication to treat RA.
Published By :
Arthritis Research & Therapy
Date :
Jan 02, 2018
