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Abatacept: A Review in Rheumatoid Arthritis

Drugs volume 77, pages 1221–1233 (2017)Cite this article

Abstract

The biological DMARD (bDMARD) abatacept (Orencia®), a recombinant fusion protein, selectively modulates a co-stimulatory signal necessary for T-cell activation. In the EU, abatacept is approved for use in patients with highly active and progressive rheumatoid arthritis (RA) not previously treated with methotrexate. Abatacept is also approved for the treatment of moderate to severe active RA in patients with an inadequate response to previous therapy with at least one conventional DMARD (cDMARD), including methotrexate or a TNF inhibitor. In phase III trials, beneficial effects on RA signs and symptoms, disease activity, structural damage progression and physical function were seen with intravenous (IV) or subcutaneous (SC) abatacept regimens, including abatacept plus methotrexate in methotrexate-naive patients with early RA and poor prognostic factors, and abatacept plus methotrexate or other cDMARDs in patients with inadequate response to methotrexate or TNF inhibitors. Benefits were generally maintained during longer-term follow-up. Absolute drug-free remission rates following withdrawal of all RA treatments were significantly higher with abatacept plus methotrexate than with methotrexate alone. Both IV and SC abatacept were generally well tolerated, with low rates of immunogenicity. Current evidence therefore suggests that abatacept is a useful treatment option for patients with RA.

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Acknowledgements

During the peer review process, the manufacturer of abatacept was also offered an opportunity to review this article. Changes resulting from comments received were made on the basis of scientific and editorial merit.

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    Hannah A. Blair & Emma D. Deeks

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Correspondence to Hannah A. Blair.

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The preparation of this review was not supported by any external funding.

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Hannah Blair and Emma Deeks are salaried employees of Adis/Springer, are responsible for the article content and declare no relevant conflicts of interest.

Additional information about this Adis Drug Review can be found at http://www.medengine.com/Redeem/0c48f0604545f656.

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The manuscript was reviewed by: C. Abud-Mendoza, Regional Unit of Rheumatology and Osteoporosis, Hospital Central Dr. Ignacio Morones Prieto, School of Medicine, Universidad Autónoma de San Luis Potosí, San Luis Potosí, Mexico; R. Alten, Department of Internal Medicine II, Rheumatology and Clinical Immunology, Schlosspark-Klinik, Charité-University Medicine Berlin, Berlin, Germany; M. Kostine, Département de Rhumatologie, Hôpital Pellegrin, Bordeaux, France; C. Richez, Département de Rhumatologie, Hôpital Pellegrin, Bordeaux, France; M. Soubrier, Service de Rhumatologie, CHU Clermont-Ferrand, Université Clermont Auvergne, Clermont-Ferrand, France.

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Blair, H.A., Deeks, E.D. Abatacept: A Review in Rheumatoid Arthritis. Drugs 77, 1221–1233 (2017). https://doi.org/10.1007/s40265-017-0775-4

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