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Title: Abatacept and Infliximab Improve ACR and LDAS in Methotrexate-Refractory RA Patients
URL: http://www.pslgroup.com/dg/223AD2.htm
Doctor's Guide
June 16, 2008

PARIS -- June 16, 2008 -- New data presented at EULAR 2008, the Annual Congress of the European League Against Rheumatism show that over half of rheumatoid arthritis (RA) patients resistant to methotrexate monotherapy improved when either abatacept or infliximab were added to their methotrexate treatment regimen, with positive results sustained up to 1 year later.

The Abatacept or Infliximab Versus Placebo, a Trial for Tolerability, Efficacy, and Safety in Treating RA (ATTEST) trial compared abatacept with infliximab plus methotrexate in 431 methotrexate-refractory patients, in a randomised, double-blind, placebo-controlled, 12-month study. Data analyses evaluated the proportion of patients who achieved a 20% improvement in symptoms (defined by the American College of Rheumatology scale as an ACR20 response) at 6 months and went on to either improve, maintain, or lose this score at 12 months. A similar analysis was conducted in relation to Low Disease Activity Score (LDAS).

Of those patients who achieved an ACR20 response at 6 months, over one-quarter of abatacept and infliximab patients went on to achieve a 50% improvement (ACR50) at 1 year. These ACR20 scores were maintained to 1 year in more abatacept than infliximab patients. Over half of the abatacept patients sustained an ACR20 improvement. Furthermore, half as many abatacept patients lost their ACR20 score between 6 months and 1 year compared with infliximab patients.

In the LDAS analysis, it was shown that 24 abatacept and 23 infliximab patients achieved LDAS at 6 months. Of these patients, over one-third of abatacept and one-quarter of infliximab patients achieved remission at 1 year. A similar number of abatacept and infliximab patients retained LDAS to 1 year, while fewer abatacept patients than infliximab patients lost their LDAS score between 6 months and 1 year.

Lead researcher Michael Schiff, MD, University of Colorado, Denver, Colorado, commented, "Since RA is a chronic disease, long-term treatment efficacy is crucial. Clinical rheumatologists and patients alike need to know the options for maintaining or even increasing treatment responses over time, especially with the growing problem of RA patients becoming refractory, or resistant, to existing treatments. Our study offers significant promise in showing that, where treatment with methotrexate as monotherapy is inadequate, both abatacept and infliximab provide an increasing magnitude of response in measures of RA disease activity, with abatacept yielding slightly higher results across some key ACR and LDAS scores."


SOURCE: European League Against Rheumatism

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