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Abatacept: A Review of its Use in the Management of Rheumatoid Arthritis

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Abstract

The biological disease-modifying antirheumatic drug abatacept (Orencia®) has a novel mechanism of action; its activity is mediated via the selective modulation of T cell co-stimulation. This article reviews the clinical efficacy and tolerability of intravenous and subcutaneous abatacept in patients with rheumatoid arthritis (RA) and intravenous abatacept in patients with juvenile idiopathic arthritis (JIA), as well as summarizing its pharmacological properties. In patients with RA, the beneficial effects of intravenous or subcutaneous abatacept on signs and symptoms, disease activity, the progression of structural damage, physical function and/or health-related quality of life were seen in a number of well-designed trials, including in methotrexate-naive patients with early RA and poor prognostic factors and in patients with established RA and an inadequate response to either methotrexate or anti-tumour necrosis factor therapy. Subcutaneous abatacept plus methotrexate was also noninferior to subcutaneous adalimumab plus methotrexate in patients with active RA who were naive to biological therapy and had an inadequate response to methotrexate. In paediatric patients with JIA, intravenous abatacept improved signs and symptoms and delayed the time to flare. Abatacept was generally well tolerated in RA and JIA and was associated with low rates of immunogenicity. In conclusion, abatacept is an important option for use in the treatment of RA and JIA.

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References

  1. Bykerk VP, Akhavan P, Hazlewood GS, et al. Canadian Rheumatology Association recommendations for pharmacological management of rheumatoid arthritis with traditional and biologic disease-modifying antirheumatic drugs. J Rheumatol. 2012;39(8):1559–82.

    Article  PubMed  CAS  Google Scholar 

  2. Levesque MC. Biologic rheumatoid arthritis therapies: do we need more comparative effectiveness data? BioDrugs. 2012;26(2):65–70.

    Article  PubMed  CAS  Google Scholar 

  3. Goldzweig O, Hashkes PJ. Abatacept in the treatment of polyarticular JIA: development, clinical utility, and place in therapy. Drug Des Devel Ther. 2011;5:61–70.

    PubMed  CAS  Google Scholar 

  4. Kuemmerle-Deschner JB, Benseler S. Abatacept in difficult-to-treat juvenile idiopathic arthritis. Biologics. 2008;2(4):865–74.

    PubMed  CAS  Google Scholar 

  5. Beukelman T, Patkar NM, Saag KG, et al. 2011 American College of Rheumatology recommendations for the treatment of juvenile idiopathic arthritis: initiation and safety monitoring of therapeutic agents for the treatment of arthritis and systemic features. Arthritis Care Res. 2011;63(4):465–82.

    Article  Google Scholar 

  6. Teng GG, Turkiewicz AM, Moreland LW. Abatacept: a costimulatory inhibitor for treatment of rheumatoid arthritis. Expert Opin Biol Ther. 2005;5(9):1245–54.

    Article  PubMed  CAS  Google Scholar 

  7. Bluestone JA, St Clair EW, Turka LA. CTLA4Ig: bridging the basic immunology with clinical application. Immunity. 2006;24(3):233–8.

    Article  PubMed  CAS  Google Scholar 

  8. Singh JA, Furst DE, Bharat A, et al. 2012 update of the 2008 American College of Rheumatology recommendations for the use of disease-modifying antirheumatic drugs and biologic agents in the treatment of rheumatoid arthritis. Arthritis Care Res (Hoboken). 2012;64(5):625–39.

    Article  CAS  Google Scholar 

  9. Corbo M, Valencia X, Raymond R, et al. Subcutaneous administration of abatacept in patients with rheumatoid arthritis: pharmacokinetics, safety and immunogenicity [abstract no. SAT0101]. Ann Rheum Dis. 2009;68(Suppl. 3):574.

    Google Scholar 

  10. Nadler S, Townsend R, Mikesell G, et al. Abatacept (CTLA4g; BMS-188667) significantly inhibits T-cell proliferation in vitro at clinically relevant concentrations [abstract no. THU0103]. Ann Rheum Dis. 2004;63:142–3.

    Google Scholar 

  11. Davis PM, Nadler SG, Rouleau KA, et al. Abatacept (CTLA4-Ig) modulates human T-cell proliferation and cytokine production but does not affect lipopolysaccharide-induced tumor necrosis factor alpha production by monocytes [abstract]. Arthritis Res Ther. 2005;7(Suppl. 1):P21.

    Article  Google Scholar 

  12. Cutolo ME, Soldano S, Montagna P, et al. CTLA-4-Ig fusion protein (abatacept) modulate inflammatory activity of cultured synovial macrophages from rheumatoid arthritis patients [abstract no. 1798]. American College of Rheumatology/Association of Rheumatology Health Professionals Annual Scientific Meeting; 7–11 Nov 2010; Atlanta (GA).

  13. Korhonen R, Moilanen E. Abatacept, a novel CD80/86-CD28 T cell co-stimulation modulator, in the treatment of rheumatoid arthritis. Basic Clin Pharmacol Toxicol. 2009;104(4):276–84.

    Article  PubMed  CAS  Google Scholar 

  14. Ruderman EM, Pope RM. The evolving clinical profile of abatacept (CTLA4-Ig): a novel co-stimulatory modulator for the treatment of rheumatoid arthritis. Arthritis Res Ther. 2005;7(Suppl. 2):S21–5.

    Article  PubMed  Google Scholar 

  15. von Kempis J, Dudler J, Hasler P, et al. Use of abatacept in rheumatoid arthritis: recommendations based on current evidence. Swiss Med Wkly. 2012;142:w13581.

    Google Scholar 

  16. Platt AM, Gibson VB, Patakas A, et al. Abatacept limits breach of self-tolerance in a murine model of arthritis via effects on the generation of T follicular helper cells. J Immunol. 2010;185(3):1558–67.

    Article  PubMed  CAS  Google Scholar 

  17. Davis PM, Abraham R, Xu L, et al. Abatacept binds to the Fc receptor CD64 but does not mediate complement-dependent cytotoxicity or antibody-dependent cellular cytotoxicity. J Rheumatol. 2007;34(11):2204–10.

    PubMed  CAS  Google Scholar 

  18. Roy A, Mould DR, Wang X-F, et al. Modeling and simulation of abatacept exposure and interleukin-6 response in support of recommended doses for rheumatoid arthritis. J Clin Pharmacol. 2007;47(11):1408–20.

    Article  PubMed  CAS  Google Scholar 

  19. Davis PM, Nadler SG, Stetsko DK, et al. Abatacept modulates human dendritic cell-stimulated T-cell proliferation and effector function independent of IDO induction. Clin Immunol. 2008;126(1):38–47.

    Article  PubMed  CAS  Google Scholar 

  20. Scarsi M, Ziglioli T, Airo P. Decreased circulating CD28-negative T cells in patients with rheumatoid arthritis treated with abatacept are correlated with clinical response. J Rheumatol. 2010;37(5):911–6.

    Article  PubMed  CAS  Google Scholar 

  21. Bonelli M, Ferner E, Göschl L, et al. Abatacept (CTLA-4Ig) treatment reduces the migratory capacity of monocytes in patients with rheumatoid arthritis. Arthritis Rheum. 2013;65(3):599–607.

    Article  PubMed  CAS  Google Scholar 

  22. Weisman MH, Durez P, Hallegua D, et al. Reduction of inflammatory biomarker response by abatacept in treatment of rheumatoid arthritis. J Rheumatol. 2006;33(11):2162–6.

    PubMed  CAS  Google Scholar 

  23. Matsubara T, Yamana S, Tohma S, et al. Tolerability and efficacy of abatacept in Japanese patients with rheumatoid arthritis: a phase I study. Mod Rheumatol. 2012. doi:10.1007/s10165-012-0722-x.

    Google Scholar 

  24. Buch MH, Boyle DL, Rosengren S, et al. Mode of action of abatacept in rheumatoid arthritis patients having failed tumour necrosis factor blockade: a histological, gene expression and dynamic magnetic resonance imaging pilot study. Ann Rheum Dis. 2009;68(7):1220–7.

    Article  PubMed  CAS  Google Scholar 

  25. Kremer JM, Dougados M, Emery P, et al. Treatment of rheumatoid arthritis with the selective costimulation modulator abatacept: twelve-month results of a phase IIb, double-blind, randomized, placebo-controlled trial. Arthritis Rheum. 2005;52(8):2263–71.

    Article  PubMed  CAS  Google Scholar 

  26. Murthy B, Gao L, Yin J, et al. Pharmacokinetics of subcutaneous abatacept support a fixed dosing regimen in adult patients with rheumatoid arthritis [abstract no. FRI0347]. Ann Rheum Dis. 2011;70(Suppl. 3):460.

    Google Scholar 

  27. Murthy B, Gao L, Vakkalagadda B, et al. Clinical pharmacokinetics of subcutaneous abatacept in the presence or absence of an intravenous loading dose in patients with rheumatoid arthritis [abstract no. FRI0346]. Ann Rheum Dis. 2011;70(Suppl. 3):459.

    Google Scholar 

  28. Bristol-Myers Squibb. Orencia (abatacept): US prescribing information. 2011. http://packageinserts.bms.com/pi/pi_orencia.pdf. Accessed 3 May 2013.

  29. European Medicines Agency. Orencia (abatacept): EU summary of product characteristics. 2012. http://www.emea.europa.eu/docs/en_GB/document_library/EPAR_-_Product_Information/human/000701/WC500048935.pdf. Accessed 3 May 2013.

  30. Hasegawa M, Imai Y, Hiraoka M, et al. Model-based determination of abatacept exposure in support of the recommended dose for Japanese rheumatoid arthritis patients. J Pharmacokinet Pharmacodyn. 2011;38(6):803–32.

    Article  PubMed  CAS  Google Scholar 

  31. Moreland LW, Alten R, Van den Bosch F, et al. Costimulatory blockade in patients with rheumatoid arthritis: a pilot, dose-finding, double-blind, placebo-controlled clinical trial evaluating CTLA-4Ig and LEA29Y eighty-five days after the first infusion. Arthritis Rheum. 2002;46(6):1470–9.

    Article  PubMed  CAS  Google Scholar 

  32. Kremer JM, Westhovens R, Leon M, et al. Treatment of rheumatoid arthritis by selective inhibition of T-cell activation with fusion protein CTLA4Ig. N Engl J Med. 2003;349(20):1907–15.

    Article  PubMed  CAS  Google Scholar 

  33. Takeuchi T, Matsubara T, Nitobe T, et al. Phase II dose-response study of abatacept in Japanese patients with active rheumatoid arthritis with an inadequate response to methotrexate. Mod Rheumatol. 2013;23(2):226–35.

    Article  PubMed  CAS  Google Scholar 

  34. Westhovens R, Kremer JM, Moreland LW, et al. Safety and efficacy of the selective costimulation modulator abatacept in patients with rheumatoid arthritis receiving background methotrexate: a 5-year extended phase IIB study. J Rheumatol. 2009;36(4):736–42.

    Article  PubMed  CAS  Google Scholar 

  35. Westhovens R, Kremer JM, Emery P, et al. Consistent safety and sustained improvement in disease activity and treatment response over 7 years of abatacept treatment in biologic-naive patients with RA [abstract no. SAT0108]. Ann Rheum Dis. 2009;68(Suppl. 3):577.

    Google Scholar 

  36. Kremer JM, Genant HK, Moreland LW, et al. Effects of abatacept in patients with methotrexate-resistant active rheumatoid arthritis: a randomized trial. Ann Intern Med. 2006;144(12):865–76.

    Article  PubMed  CAS  Google Scholar 

  37. Schiff M, Keiserman M, Codding C, et al. Efficacy and safety of abatacept or infliximab vs placebo in ATTEST: a phase III, multi-centre, randomised, double-blind, placebo-controlled study in patients with rheumatoid arthritis and an inadequate response to methotrexate. Ann Rheum Dis. 2008;67(8):1096–103.

    Article  PubMed  CAS  Google Scholar 

  38. Conaghan PG, Durez P, Alten RE, et al. Impact of intravenous abatacept on synovitis, osteitis and structural damage in patients with rheumatoid arthritis and an inadequate response to methotrexate: the ASSET randomised controlled trial. Ann Rheum Dis. 2012. doi:10.1136/annrheumdis-2012-201611.

    Google Scholar 

  39. Genovese MC, Becker J-C, Schiff M, et al. Abatacept for rheumatoid arthritis refractory to tumor necrosis factor α inhibition. N Engl J Med. 2005;353(11):1114–23.

    Article  PubMed  CAS  Google Scholar 

  40. Westhovens R, Robles M, Ximenes AC, et al. Clinical efficacy and safety of abatacept in methotrexate-naive patients with early rheumatoid arthritis and poor prognostic factors. Ann Rheum Dis. 2009;68(12):1870–7.

    Article  PubMed  CAS  Google Scholar 

  41. Schiff M, Pritchard C, Huffstutter JE, et al. The 6-month safety and efficacy of abatacept in patients with rheumatoid arthritis who underwent a washout after anti-tumour necrosis factor therapy or were directly switched to abatacept: the ARRIVE trial. Ann Rheum Dis. 2009;68(11):1708–14.

    Article  PubMed  CAS  Google Scholar 

  42. Nüβlein H, Alten R, Galeazzi M, et al. Real-world efficacy and safety of abatacept treatment for RA: 12-month interim analysis of the ACTION study [abstract no. AB0531]. Ann Rheum Dis. 2012;71(Suppl. 3):668.

    Google Scholar 

  43. Nüβlein H, Alten R, Galeazzi M, et al. Effect of prior therapy on the efficacy and safety of abatacept: 6-month analysis of the ACTION study [abstract no. AB0532]. Ann Rheum Dis. 2012;71(Suppl. 3):668.

    Google Scholar 

  44. Gottenberg JE, Ravaud P, Cantagrel A, et al. Positivity for anti-cyclic citrullinated peptide is associated with a better response to abatacept: data from the ‘Orencia and Rheumatoid Arthritis’ registry. Ann Rheum Dis. 2012;71(11):1815–9.

    Article  PubMed  CAS  Google Scholar 

  45. Genant HK, Peterfy C, Westhovens R, et al. Abatacept increases the proportion of patients who remain free from structural damage progression through 5 years in methotrexate inadequate responders with RA [abstract no. FRI0253]. Ann Rheum Dis. 2009;68(Suppl. 3):440.

    Google Scholar 

  46. Durez P, Bathon J, Becker JC, et al. Time course of improvement in ACR core components in patients with early rheumatoid arthritis (RA) treated with abatacept (ABA) + methotrexate (MTX) [abstract no. FRI0201]. Ann Rheum Dis. 2010;69(Suppl. 3):382.

    Google Scholar 

  47. Westhovens R, Dougados M, Hall S, et al. Disease remission, radiographic non-progression and normalization of function achieved at year 1 are sustained long-term in a majority of patients: 5-year outcomes with abatacept in biologic-naive patients [abstract no. 1657]. 2009 American College of Rheumatology/Association of Rheumatology Health Professionals Annual Scientific Meeting; 16–21 Oct 2009; Philadelphia (PA).

  48. Bathon J, Robles M, Ximenes AC, et al. Sustained disease remission and inhibition of radiographic progression in methotrexate-naive patients with rheumatoid arthritis and poor prognostic factors treated with abatacept: 2-year outcomes. Ann Rheum Dis. 2011;70(11):1949–56.

    Article  PubMed  CAS  Google Scholar 

  49. Wells AF, Westhovens R, Reed DM, et al. Abatacept plus methotrexate provides incremental clinical benefits versus methotrexate alone in methotrexate-naive patients with early rheumatoid arthritis who achieve radiographic nonprogression. J Rheumatol. 2011;38(11):2362–8.

    Article  PubMed  CAS  Google Scholar 

  50. Kremer JM, Genant HK, Moreland LW, et al. Results of a two-year followup study of patients with rheumatoid arthritis who received a combination of abatacept and methotrexate. Arthritis Rheum. 2008;58(4):953–63.

    Article  PubMed  CAS  Google Scholar 

  51. Genant HK, Peterfy CG, Westhovens R, et al. Abatacept inhibits progression of structural damage in rheumatoid arthritis: results from the long-term extension of the AIM trial. Ann Rheum Dis. 2008;67(8):1084–9.

    Article  PubMed  CAS  Google Scholar 

  52. Kremer JM, Russell AS, Emery P, et al. Long-term safety, efficacy and inhibition of radiographic progression with abatacept treatment in patients with rheumatoid arthritis and an inadequate response to methotrexate: 3-year results from the AIM trial. Ann Rheum Dis. 2011;70(10):1826–30.

    Article  PubMed  CAS  Google Scholar 

  53. Schiff M, Keiserman M, Codding C, et al. Clinical response and tolerability to abatacept in patients with rheumatoid arthritis previously treated with infliximab or abatacept: open-label extension of the ATTEST Study. Ann Rheum Dis. 2011;70(11):2003–7.

    Article  PubMed  CAS  Google Scholar 

  54. Russell AS, Wallenstein GV, Li T, et al. Abatacept improves both the physical and mental health of patients with rheumatoid arthritis who have inadequate response to methotrexate treatment. Ann Rheum Dis. 2007;66(2):189–94.

    Article  PubMed  CAS  Google Scholar 

  55. Wells G, Li T, Tugwell P. Investigation into the impact of abatacept on sleep quality in patients with rheumatoid arthritis, and the validity of the MOS-Sleep questionnaire Sleep Disturbance Scale. Ann Rheum Dis. 2010;69(10):1768–73.

    Article  PubMed  Google Scholar 

  56. Li T, Gignac M, Wells G, et al. Decreased external home help use with improved clinical status in rheumatoid arthritis: an exploratory analysis of the Abatacept in Inadequate responders to Methotrexate (AIM) trial. Clin Ther. 2008;30(4):734–48.

    Article  PubMed  CAS  Google Scholar 

  57. Genovese MC, Schiff M, Luggen M, et al. Efficacy and safety of the selective co-stimulation modulator abatacept following 2 years of treatment in patients with rheumatoid arthritis and an inadequate response to anti-tumour necrosis factor therapy. Ann Rheum Dis. 2008;67(4):547–54.

    Article  PubMed  CAS  Google Scholar 

  58. Genovese MC, Schiff M, Luggen M, et al. Longterm safety and efficacy of abatacept through 5 years of treatment in patients with rheumatoid arthritis and an inadequate response to tumor necrosis factor inhibitor therapy. J Rheumatol. 2012;39(8):1546–54.

    Article  PubMed  CAS  Google Scholar 

  59. Westhovens R, Cole JC, Li T, et al. Improved health-related quality of life for rheumatoid arthritis patients treated with abatacept who have inadequate response to anti-TNF therapy in a double-blind, placebo-controlled, multicentre randomized clinical trial. Rheumatology (Oxford). 2006;45(10):1238–46.

    Article  CAS  Google Scholar 

  60. Li T, Wells G, Westhovens R, et al. Improvements in participation in usual daily activities in patients with rheumatoid arthritis treated with abatacept. Value Health. 2011;14(2):361–70.

    Article  PubMed  Google Scholar 

  61. Corbo M, Valencia X, Raymond R, et al. A subcutaneous administration regimen for abatacept in patients with rheumatoid arthritis: pharmacokinetics, safety and immunogenicity [abstract no. 376]. Arthritis Rheum. 2008;58(Suppl. 9):S307.

    Google Scholar 

  62. Genovese MC, Covarrubias A, Leon G, et al. Subcutaneous abatacept versus intravenous abatacept: a phase IIIb noninferiority study in patients with an inadequate response to methotrexate. Arthritis Rheum. 2011;63(10):2854–64.

    Article  PubMed  CAS  Google Scholar 

  63. Matsubara T, Inoue H, Iwahashi M, et al. A multi-center, double-dummy, double-blind study of subcutaneous (SC) abatacept (ABA) compared with intraveneous (IV) ABA in Japanese rheumatoid arthritis patients with inadequate response to methotrexate [abstract no. THU0125]. Ann Rheum Dis. 2012;71(Suppl. 3):197.

    Google Scholar 

  64. Keystone EC, Kremer JM, Russell A, et al. Abatacept in subjects who switch from intravenous to subcutaneous therapy: results from the phase IIIb ATTUNE study. Ann Rheum Dis. 2012;71(6):857–61.

    Article  PubMed  CAS  Google Scholar 

  65. Weinblatt ME, Schiff M, Valente R, et al. Head-to-head comparison of subcutaneous abatacept versus adalimumab for rheumatoid arthritis: findings of a phase IIIb, multinational, prospective, randomized study. Arthritis Rheum. 2013;65(1):28–38.

    Article  PubMed  CAS  Google Scholar 

  66. Kaine J, Gladstein G, Strusberg I, et al. Evaluation of abatacept administered subcutaneously in adults with active rheumatoid arthritis: impact of withdrawal and reintroduction on immunogenicity, efficacy and safety (phase IIIb ALLOW study). Ann Rheum Dis. 2012;71(1):38–44.

    Article  PubMed  CAS  Google Scholar 

  67. Nash P, Nayiager S, Genovese MC, et al. Immunogenicity, safety and efficacy of abatacept administered subcutaneously with or without background methotrexate in patients with rheumatoid arthritis: results from a phase III, international, multicenter, parallel-arm, open-label study. Arthritis Care Res. 2013;65(5):718–28.

    Article  CAS  Google Scholar 

  68. Genovese MC, Cobos AC, Leon G, et al. Subcutaneous (SC) abatacept (ABA) versus intravenous (IV) ABA in patients (pts) with rheumatoid arthritis: long-term data from the ACQUIRE (Abatacept Comparison of Sub[QU]cutaneous versus Intravenous in Inadequate Responders to Methotrexate) trial [abstract no. 402]. 2011 Annual Scientific Meeting of the American College of Rheumatology and Association of Rheumatology Health Professionals; 5–9 Nov 2011; Chicago (IL).

  69. Schiff M, Weinblatt M, Valente R, et al. Head-to-head comparison of subcutaneous abatacept versus adalimumab on background methotrexate in RA: two year results from the AMPLE study [abstract no. OP0044]. 2013 Annual European Congress of Rheumatology; 12–15 Jun 2013; Madrid.

  70. Ruperto N, Lovell DJ, Quartier P, et al. Abatacept in children with juvenile idiopathic arthritis: a randomised, double-blind, placebo-controlled withdrawal trial. Lancet. 2008;372(9636):383–91.

    Article  PubMed  CAS  Google Scholar 

  71. Ruperto N, Lovell DJ, Quartier P, et al. Long-term safety and efficacy of abatacept in children with juvenile idiopathic arthritis. Arthritis Rheum. 2010;62(6):1792–802.

    Article  PubMed  CAS  Google Scholar 

  72. Ruperto N, Lovell DJ, Li T, et al. Abatacept improves health-related quality of life, pain, sleep quality, and daily participation in subjects with juvenile idiopathic arthritis. Arthritis Care Res. 2010;62(11):1542–51.

    Article  Google Scholar 

  73. Weinblatt M, Combe B, Covucci A, et al. Safety of the selective costimulation modulator abatacept in rheumatoid arthritis patients receiving background biologic and nonbiologic disease-modifying antirheumatic drugs: a one-year randomized, placebo-controlled study. Arthritis Rheum. 2006;54(9):2807–16.

    Article  PubMed  CAS  Google Scholar 

  74. Weinblatt ME, Moreland LW, Westhovens R, et al. Safety of abatacept administered intravenously in treatment of rheumatoid arthritis: integrated analyses of up to 8 years of treatment from the abatacept clinical trial program. J Rheumatol. 2013. doi:10.3899/jrheum.120906.

    Google Scholar 

  75. Alten R, Kaine J, Keystone E, et al. Safety of SC abatacept in patients with RA: update from pooled clinical trial data [abstract no. AB0567]. Ann Rheum Dis. 2012;71(Suppl. 3):670.

    Google Scholar 

  76. Simon TA, Askling J, Lacaille D, et al. Infections requiring hospitalization in the abatacept clinical development program: an epidemiological assessment. Arthritis Res Ther. 2010;12(2):R67.

    Article  PubMed  Google Scholar 

  77. Simon TA, Smitten AL, Franklin J, et al. Malignancies in the rheumatoid arthritis abatacept clinical development programme: an epidemiological assessment. Ann Rheum Dis. 2009;68(12):1819–26.

    Article  PubMed  CAS  Google Scholar 

  78. Weinblatt ME, Genovese MC, Schiff MH, et al. Immunogenicity is low and transient with intravenous (IV) abatacept therapy: results from a large pooled analysis of 3985 patients (pts) with rheumatoid arthritis (RA) and up to 8 years’ exposure [abstract no. 2191]. 2011 American College of Rheumatology and Association of Rheumatology Health Professionals Annual Scientific Meeting; 5–9 Nov 2011; Chicago (IL).

  79. Russell AS, Kremer JM, Emery P, et al. Safety and efficacy of abatacept over 4 years of treatment in patients with rheumatoid arthritis and an inadequate response to methotrexate in the AIM trial [abstract no. 153]. J Rheumatol. 2009;36(11):2608–9.

    Google Scholar 

  80. Smitten AL, Choi HK, Hochberg MC, et al. The risk of hospitalized infection in patients with rheumatoid arthritis. J Rheumatol. 2008;35(3):387–93.

    PubMed  Google Scholar 

  81. Smitten AL, Simon TA, Hochberg MC, et al. A meta-analysis of the incidence of malignancy in adult patients with rheumatoid arthritis. Arthritis Res Ther. 2008;10(2):R45.

    Article  PubMed  Google Scholar 

  82. Orencia (abatacept) for I.V. infusion: Japanese prescribing information. 2010. http://www.orencia.jp/pdf/product/tenpu.pdf. Accessed 3 May 2012.

  83. Guyot P, Taylor P, Christensen R, et al. Abatacept with methotrexate versus other biologic agents in treatment of patients with active rheumatoid arthritis despite methotrexate: a network meta-analysis. Arthrtis Res Ther. 2011;13:R204.

    Article  CAS  Google Scholar 

  84. Smolen JS, Landewé R, Breedveld FC, et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs. Ann Rheum Dis. 2010;69(6):964–75.

    Article  PubMed  CAS  Google Scholar 

  85. Martín Mola E, Balsa A, Martínez Taboada V, et al. Abatacept use in rheumatoid arthritis: evidence review and recommendations. Reumatol Clin. 2013;9(1):5–17.

    PubMed  Google Scholar 

  86. Westhovens R, Verschueren P. The efficacy and safety of abatacept in rheumatoid arthritis. Ther Adv Musculoskelet Dis. 2010;2(2):89–94.

    Article  PubMed  CAS  Google Scholar 

  87. European Medicines Agency. Remicade (infliximab): EU summary of product characteristics. 2012. http://www.emea.europa.eu/docs/en_GB/document_library/EPAR_-_Product_Information/human/000240/WC500050888.pdf. Accessed 3 May 2013.

  88. Janssen Biotech Inc. Remicade (infliximab): US prescribing information. 2011. http://www.remicade.com/remicade/assets/hcp_ppi.pdf. Accessed 3 May 2013.

  89. Weinblatt M, Schiff M, Goldman A, et al. Selective costimulation modulation using abatacept in patients with active rheumatoid arthritis while receiving etanercept: a randomised clinical trial. Ann Rheum Dis. 2007;66(2):228–34.

    Article  PubMed  CAS  Google Scholar 

  90. Schoels M, Wong J, Scott DL, et al. Economic aspects of treatment options in rheumatoid arthritis: a systematic literature review informing the EULAR recommendations for the management of rheumatoid arthritis. Ann Rheum Dis. 2010;69(6):995–1003.

    Article  PubMed  Google Scholar 

  91. Malottki K, Barton P, Tsourapas A, et al. Adalimumab, etanercept, infliximab, rituximab and abatacept for the treatment of rheumatoid arthritis after the failure of a tumour necrosis factor inhibitor: a systematic review and economic evaluation. Health Technol Assess. 2011;15(14):1–278.

    PubMed  CAS  Google Scholar 

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The preparation of this review was not supported by any external funding. During the peer review process, the manufacturer of the agent under review was offered an opportunity to comment on this article. Changes resulting from comments received were made by the author on the basis of scientific and editorial merit.

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Correspondence to Gillian M. Keating.

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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, Clinical Immunology & Osteology, Schlosspark-Klinik, Charité-University Medicine Berlin, Berlin, Germany; D. E. Furst, University of California Los Angeles, Los Angeles, CA, USA; F. Navarro Sarabia, Rheumatology Department, Hospital Universitario Virgen Macarena, Seville, Spain; C. Richez, Département de Rhumatologie, Hôpital Pellegrin, Bordeaux, France; R. Sanmartí, Arthritis Unit, Rheumatology Service, Hospital Clinic of Barcelona, Barcelona, Spain.

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Keating, G.M. Abatacept: A Review of its Use in the Management of Rheumatoid Arthritis. Drugs 73, 1095–1119 (2013). https://doi.org/10.1007/s40265-013-0080-9

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