A proof-of-concept prospective, open-label study has shown that abatacept has promise as a treatment for patients with anti-citrullinated protein antibody (ACPA)-negative undifferentiated arthritis (UA) and poor prognosis (power Doppler ultrasonography (PDUS) score ≥1). The primary end point was a composite of DAS44 remission (DAS44 <1.6, where DAS44 is the disease activity score incorporating 44-joint swollen joint count, Ritchie Articular Index and erythrocyte sedimentation rate), a maximum of one swollen joint for ≥3 consecutive months, and no measured radiographic progression at 6 months. Two of the 20 (10%) patients treated with abatacept monotherapy for 6 months achieved the defined primary end point, and six (30%) achieved DAS44 remission (95% Cl 15–51%) by 6 months. By 12 months, 8/20 (40%) patients achieved DAS44 remission (95% CI 22–61%); the mean DAS44 was reduced from 2.66 to 1.78 and the median PDUS score reduced from 10 to 3 at this time point.
References
Buch, M. H. et al. Abatacept reduces disease activity and ultrasound power Doppler in ACPA-negative undifferentiated arthritis: a proof-of-concept clinical and imaging study. Rheumatology (Oxford) http://dx.doi.org/10.1093/rheumatology/kew357 (2016)
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McHugh, J. Abatacept for treating ACPA-negative UA?. Nat Rev Rheumatol 12, 692 (2016). https://doi.org/10.1038/nrrheum.2016.188
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DOI: https://doi.org/10.1038/nrrheum.2016.188