NEW YORK (Reuters Health) - A direct switch to abatacept (Orencia) with no washout period is safe and effective in rheumatoid arthritis (RA) patients with inadequate responses to anti-tumor necrosis factor (TNF) agents.
In the November issue of Annals of the Rheumatic Diseases, Dr. M. Schiff of the University of Colorado, Greenwood Village and colleagues report on an open-label study of 1046 such patients. Of the group, 597 directly switched to abatacept (~10 mg/kg), while the remainder did so after stopping anti-TNF therapy for at least 2 months.
At 6 months, the direct switch and washout groups had comparable rates of total adverse events (79.2% vs. 78.0%), serious adverse events (9.9% vs. 11.19%), and discontinuations because of such events.
The direct switch and washout groups also showed comparable proportions of patients with greater than 1.2 unit improvement in disease activity score in 28 joints (53.6% and 59.5%, respectively). Both groups also demonstrated a more than 20% increase in low activity score.
There were also similar between-group improvements in a variety of other measures including remission, physical function and quality of life.
Thus, Dr. Schiff told Reuters Health that the findings "show the clinician one can switch from an anti-TNF agent to abatacept without a washout period. This large trial... also confirms the safety of abatacept."
Ann Rheum Dis 2009;68:1708-1714.