Higher remission rates with abatacept seen in early RA.

PARIS -- Patients with early rheumatoid arthritis had greater improvements with abatacept treatment than did those with longstanding disease, according to a new post hoc analysis of two clinical trials.

In the first report of the efficacy of this selective T-cell costimulation modulator in patients whose disease duration is 2 years or less and who have an inadequate response to methotrexate but are biologic naive, almost half were in disease remission at year 3, according to Dr. Yusuf Yazici.

This study included 462 patients who had been randomized to receive abatacept 10 mg/kg once monthly and who had entered a long-term extension phase, with assessments at years 1 and 3.

Patients' mean age was 55 years, 76% were female, and 82% were rheumatoid factor positive. Mean baseline Disease Activity Score 28 (DAS28) was 6.4, Health Assessment Questionnaire (HAQ) was 1.5, and C-reactive protein (CRP) was 3.2 mg/dL.

Among the entire cohort, 25% were in DAS28 remission at year 1, as were 36% at year 3, said Dr. Yazici of New York University, and director of the Seligman Center for Advanced Therapeutics, NYU Hospital for Joint Diseases, New York.

A total of 108 patients had early disease, while 159 had longstanding disease. Comparison of these groups determined that 46% of those with early disease were in remission at year 3, compared with 31% of those with longstanding disease, Dr. Yusuf Yazici said at the annual European Congress of Rheumatology. Rheumatoid Arthristis Response to Abatacept Greater Early in Disease

Early disease (duration [less Long-standing disease (duration

than or equal to]2 years) > 10 years)

ACR 70 Response HAQ Score Improvement of

[greater than or equal to]0.3 Year 1 37% 25% Year 3 44% 31% Year 1 75% 60% Year 3 70% 64% Note: Table made from bar graph.

Remission rates were also significantly better for the early disease group at year 1 and year 3, as were ACR 70 rates. Moreover, among the early disease group, significantly more patients had clinically meaningful improvements in their HAQ scores. (See box.)

Dr. Yazici said he is a consultant for BMS, Roche, Celgene, UCB, Pfizer, and Centocor.