Abstract
Opinion statementAbatacept is the only T cell co-stimulation modulator approved thus far for the treatment of moderate-to-severe rheumatoid arthritis (RA) and is licensed for use in patients with an inadequate response to methotrexate (MTX) and/or anti-tumor necrosis factor (anti-TNF) therapy. The upstream mechanism of action of abatacept leads to downstream effects in a variety of cell types associated with the production of autoantibodies and pro-inflammatory cytokines implicated in RA. Accumulating data also suggest effects on other cells involved in the pathogenesis of RA, including regulatory T cells and osteoclasts. Clinical trials have demonstrated that abatacept is an effective and well-tolerated treatment in RA. More recently, evidence from the Assessing Very Early Rheumatoid arthritis Treatment (AVERT) trial showed that complete drug-free remission following treatment with abatacept may be a possibility in some patients with early RA, indicating that the disease course could be altered by early intervention. Equivalent efficacy and onset of action of abatacept and anti-TNF therapy have also been demonstrated in patients with an inadequate response to MTX in the Abatacept versus adaliMumab comParison in bioLogic-naïvE rheumatoid arthritis subjects with background methotrexate (AMPLE) trial. Together, these findings support the use of abatacept in early and established RA.
Highlights
Opinion statementAbatacept is the only T cell co-stimulation modulator approved far for the treatment of moderate-to-severe rheumatoid arthritis (RA) and is licensed for use in patients with an inadequate response to methotrexate (MTX) and/or anti-tumor necrosis factor (anti-TNF) therapy
In rheumatoid arthritis (RA), complex co-stimulationdependent interactions between dendritic cells, T cells, and B cells underlie the generation of an autoimmune response to citrullinated self-proteins
Abatacept is the first and only selective T cell co-stimulation modulation agent approved for the treatment of moderate-to-severe RA
Summary
Abatacept is the only T cell co-stimulation modulator approved far for the treatment of moderate-to-severe rheumatoid arthritis (RA) and is licensed for use in patients with an inadequate response to methotrexate (MTX) and/or anti-tumor necrosis factor (anti-TNF) therapy. Equivalent efficacy and onset of action of abatacept and anti-TNF therapy have been demonstrated in patients with an inadequate response to MTX in the Abatacept versus adaliMumab comParison in bioLogicnaïvE rheumatoid arthritis subjects with background methotrexate (AMPLE) trial. Together, these findings support the use of abatacept in early and established RA
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