Abstract
Objective: Long term use of biologic agent (BIO) in patients with rheumatoid arthritis (RA) sometimes results in secondary failure or causes adverse events. Abatacept (ABT) is known to inhibit the CD28:CD80/86 pathway resulting in downregulation of T cell activation. We hypothesize that the biological effects are regained by administration of ABT in the case of secondary failure.
Method: Twenty-one RA (15 female, mean age =of 61 years) were enrolled in this trial.
The mean duration of illness was 13 years. The biologic effects of first BIO continued at least 6 months in these cases whose mean dosing period was 37 months. After discontinuation of first BIO, ABT was dosed twice at two-week intervals (500mg or 750mg depending on the body weight). The DAS28CRP index was evaluated at the time of first BIO discontinuation, and 3 months and 6 months after ABT administration.
Results: The DAS28CRP index was significantly (p<0.01) improved after 3 months (3.17±1.44) and 6 months (2.62±0.98) after ABT administration compared with that at the time of the first BIO discontinuation (4.84±0.73).
Conclusion: In the 21 RA patients that had experienced secondary failure of the first BIO, the disease activity declined after administration of ABT. These results suggest the utility of ABT administration to overcome secondary failure in patients with RA.
