In a nutshell
The authors evaluated the effect of abatacept (Orencia) plus methotrexate (Trexall) in reducing the symptoms (remission) of early rheumatoid arthritis.
Some background
In rheumatoid arthritis (RA), the immune system begins attacking healthy tissues the way it normally attacks viruses or bacteria. This can cause inflammation, leading to chronic pain. The goal of RA therapy is to achieve remission (reduction of symptoms) or low disease activity (LDA) for as long as possible.
Abatacept is a protein drug used to treat early RA. In previous studies, it was shown that progression of joint damage was restricted for 6 months after stopping the therapy. It would be beneficial to know if treatment with abatacept could result in longer remission of RA.
Methods & findings
The authors aimed to assess the maintenance of remission of RA after treatment with abatacept and methotrexate.
351 patients were included in this study. 119 patients were randomly assigned to receive subcutaneous (injection under skin) abatacept plus methotrexate (group 1). 116 patients received methotrexate only (group 2). 116 patients received only subcutaneous abatacept (group 3). For patients with low disease activity at 12 months, RA treatment was stopped for another 12 months. The number of patients having low disease activity or remission was compared between group 1, group 2, and group 3 patients.
After 12 months of therapy, 60.9% of patients in group 1 were considered to be in disease remission. This was compared to 45.2% of patients in group 2 and 42.5% of patients in group 3. At 12 months and 18 months after stopping the treatment, 14.8% patients in group 1 were still in disease remission. This was compared to 7.8% of patients in group 2 and 12.4% in group 3.
During the treatment, the adverse events were similar in all 3 groups.
The bottom line
The authors concluded that treatment with abatacept plus methotrexate was safe and showed maintenance of RA remission following withdrawal of the treatment.
What’s next?
Discuss the use of abatacept with your physician.
Published By :
Annals of the rheumatic diseases
Date :
Nov 03, 2014
