Abatacept, a member of a new class of drug that targets immune cells to treat rheumatoid arthritis (RA), is effective against RA, according to a new Cochrane Systematic Review. The review examines recent trials to assess safety and efficacy of the drug.
RA is an autoimmune disease affecting up to 1 in 100 people in Western countries. RA patients experience chronic pain and inflammation as a result of the body's own immune system attacking the lining of the joints. Abatacept is a new "biologic" drug that works by blocking the actions of the immune cells, called T cells, which cause joint inflammation.
The review combined data from seven trials including 2,908 patients, whose symptoms were assessed after one year of taking the drug or a placebo. Compared to placebo, patients given abatacept were twice as likely to achieve a 50% improvement in symptoms, including pain and the number of tender and swollen joints. Patients who took the drug also experienced improvements in physical ability. There was no progression in damage to joints of people who took abatacept at 12 months follow up. However, serious adverse effects increased if the drug was given in combination with other biologics.
"Like other biologics, abatacept is an expensive drug, but if the benefits are evident, it may be of great interest to patients with rheumatoid arthritis who fail standard therapy or other biologic treatment. Our review shows that it is indeed effective, and generally well-tolerated, but we would strongly recommend that it is not used with other biologics," says lead researcher, Lara Maxwell, of the Institute of Population Health at the University of Ottawa in Ontario, Canada.
"There is a need for more long term studies to determine whether the drug is safe and the effect sustained over longer periods. Better designed studies in the future are likely to have a longer follow-up and high retention rates, and it would be useful to conduct trials of one biologic versus another."
- Maxwell L, Singh JA. Abatacept for rheumatoid arthritis. Cochrane Database of Systematic Reviews, 2009, Issue 4. Art. No.: CD007277 DOI: 10.1002/14651858.CD007277.pub2
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