Abatacept for Rheumatoid Arthritis Refractory to Tumor Necrosis Factor α Inhibition

Genovese, Mark C.; Becker, Jean‐Claude; Schiff, Michael; Luggen, Michael E.; Sherrer, Yvonne; Kremer, Joel; Birbara, C.; Box, Jane; Natarajan, Kannan; Nuamah, Isaac; Li, Tracy; Aranda, Richard; Hagerty, David; Dougados, Maxime

doi:10.1056/nejmoa050524

Cited by 1,127 publications

(849 citation statements)

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“…However, the remission rates of these non-TNF biologic agents in anti-TNF-naïve or -refractory populations differ. For abatacept, the remission rate in MTX-resistant patients (AIM study) was 14.8% [28], while that in anti-TNF therapy-refractory patients (ATTAIN study) was 10.0% [29]. In the case of rituximab, the American College of Rheumatology (ACR) 70% rate in MTX-resistant patients (DANCER study) was 20% [30], and that in anti-TNF therapy-refractory patients (REFLEX study) was 12% [31].…”

Section: Discussionmentioning

confidence: 99%

Efficacy and tolerability of tocilizumab in rheumatoid arthritis patients seen in daily clinical practice in Japan: results from a retrospective study (REACTION study)

et al. 2010

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Tocilizumab, a humanized monoclonal antibody to the interleukin 6 (IL-6) receptor, was approved for use as rheumatoid arthritis (RA) therapy in Japan in 2008, but its efficacy and tolerability in daily practice has not yet been reported. We report the results of a multicenter retrospective study on the efficacy and safety of tocilizumab involving all patients (n = 229) who were started on tocilizumab therapy at three rheumatology institutes in Japan from April 2008 through to March 2009. Tocilizumab was infused every 4 weeks at a dose of 8 mg/kg according to the drug labeling. Among the 229 patients, 55% concomitantly received methotrexate (MTX) and 63% had previously received anti-tumor necrosis factor (TNF) therapy. Average disease activity score (DAS) 28 of all 229 patients significantly decreased from 5.70 to 3.25 after 24 weeks of therapy. A European League Against Rheumatism (EULAR) good response and DAS28 remission was achieved in 57.4 and 40.7% of the patients, respectively, at 24 weeks. White blood cell counts significantly decreased and liver enzymes and total cholesterol slightly but significantly increased; however, liver enzyme levels did not increase in patients without MTX. Tocilizumab was discontinued in 47 cases (20.5%) due to lack of efficacy (5.2%), adverse events (11.4%), and other reasons (3.9%). The overall retention rate at 24 weeks was 79.5%. Based on these results, we conclude that tocilizumab therapy in daily rheumatology practice appears to be highly efficacious and well tolerated among active RA patients, including the anti-TNF therapy-refractory population. Tocilizumab infusion is therefore applicable not only as an alternative approach for anti-TNF therapy-resistant patients, but also as primary biologic therapy for active RA patients.

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Section: Discussionmentioning

confidence: 99%

Efficacy and tolerability of tocilizumab in rheumatoid arthritis patients seen in daily clinical practice in Japan: results from a retrospective study (REACTION study)

et al. 2010

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“…In patients already receiving combined MTX plus biologic therapy (either a TNF inhibitor or abatacept), treatment with an alternative biologic response modifier should be initiated. Abatacept is more effective than placebo in patients with inadequate response to TNF inhibitors 82 and has a good safety record. 83 A single trial of switching to another TNF inhibitor is appropriate and can be effective; however, additional trials of anti-TNF agents are not likely to be so beneficial as switching to a drug with an alternative mechanism of action.…”

Section: Six To 12 Months Of Diseasementioning

confidence: 99%

My Treatment Approach to Rheumatoid Arthritis

Davis

Matteson

2012

Mayo Clinic Proceedings

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The past decade has brought important advances in the understanding of rheumatoid arthritis and its management and treatment. New classification criteria for rheumatoid arthritis, better definitions of treatment outcome and remission, and the introduction of biologic response-modifying drugs designed to inhibit the inflammatory process have greatly altered the approach to managing this disease. More aggressive management of rheumatoid arthritis early after diagnosis and throughout the course of the disease has resulted in improvement in patient functioning and quality of life, reduction in comorbid conditions, and enhanced survival.

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“…Abatacept has been shown to reduce disease activity and improve quality of life (QoL) in this difficult-to-treat patient population [29,30]. T-cell modulation with abatacept was evaluated in patients with moderate to severely active RA who had failed at least 3 months of TNF-α antagonist therapy in the ATTAIN (Abatacept Trial in Treatment of Anti-TNF INadequate responders) trial [29].…”

Section: Clinical Overview Of Abatacept In Patients With Ra Refractormentioning

confidence: 99%

“…T-cell modulation with abatacept was evaluated in patients with moderate to severely active RA who had failed at least 3 months of TNF-α antagonist therapy in the ATTAIN (Abatacept Trial in Treatment of Anti-TNF INadequate responders) trial [29]. In this trial, 258 patients were randomized to abatacept and 133 patients to placebo, with both being administered by intravenous infusion.…”

Section: Clinical Overview Of Abatacept In Patients With Ra Refractormentioning

confidence: 99%

Abatacept: a T-cell co-stimulation modulator for the treatment of rheumatoid arthritis

Östör

2008

Clin Rheumatol

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Abatacept for Rheumatoid Arthritis Refractory to Tumor Necrosis Factor α Inhibition

Abstract: Abatacept produced significant clinical and functional benefits in patients who had had an inadequate response to anti-TNF-alpha therapy.

Cited by 1,127 publications

References 23 publications

Efficacy and tolerability of tocilizumab in rheumatoid arthritis patients seen in daily clinical practice in Japan: results from a retrospective study (REACTION study)

Efficacy and tolerability of tocilizumab in rheumatoid arthritis patients seen in daily clinical practice in Japan: results from a retrospective study (REACTION study)

My Treatment Approach to Rheumatoid Arthritis

Abatacept: a T-cell co-stimulation modulator for the treatment of rheumatoid arthritis

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