EDITORIAL - Have we ARRIVEd at intiating Orencia right after anti-TNF failure?

[Guest guest]

Have We ARRIVEd at Initiating Abatacept Right After Anti-TNF Treatment Failure?

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

Deane, MD

Posted: 28 Dec 2009

Schiff M, Pritchard C, Huffstutter JE, et al

Ann Rheum Dis. 2009; 68:1708-1714

Study Summary

Patients with rheumatoid arthritis (RA) fail anti-tumor necrosis

factor (TNF) therapy for a variety of reasons, including lack of

efficacy, drug intolerance, and adverse events (AEs). Additional

biologic therapies, such as the selective T-cell costimulation

modulator abatacept, are approved for use after failure of an anti-TNF

agent. However, little data are available for when abatacept may be

safely started after failure of an anti-TNF agent. To address this

issue, the safety and efficacy of abatacept given either right after

cessation or after a washout period were evaluated in patients with RA

post anti-TNF therapy.

Some disagreement exists between the introduction and the methods;

overall, it appears that patients qualified for the study if they had

inadequate response of at least 3 months of an anti-TNF agent or had

safety or tolerability issues. Patients had a disease activity score

in 28 joints (DAS28 [C-reactive protein]) of ≥ 5.1, which is

indicative of active disease. Background non-biological

disease-modifying antirheumatic drugs had to be stable for about 1

month before enrollment. A fixed dose of abatacept of approximately 10

mg/kg was administered in an open-label fashion.

******************************************

Read the full article here:

http://www.medscape.com/viewarticle/714092

Not an MD