New study compares two drugs combined with methotrexate for rheumatoid arthritis treatment
Research is ongoing for effective treatment of the debilitating condition of rheumatoid arthritis. With the approval of a new product, rheumatoid arthritis sufferers hold out the hope that it will be effective for them. Even after release, the pharmaceuticals are the subject of ongoing evaluation. A new study was conducted to compare the efficacy of abatacept to adalimumab both with background methotrexate. Researchers affiliated with Brigham and Women's Hospital, Boston, Massachusetts published their findings online on November 20 in the journal Arthritis and rheumatism.
The researchers noted that a need exists for comparative studies to provide evidence-based treatment guidance for biologics in rheumatoid. Therefore, the designed the first head-to-head study in rheumatoid arthritis, which compared subcutaneous abatacept versus adalimumab both with background methotrexate. The primary end point was the ACR20 response at one year. The ACR score is a scale to measure change in rheumatoid arthritis symptoms. It is named after the American College of Rheumatology.
Patients with active rheumatoid arthritis who had not received biologic therapy and had exhibited an inadequate response to methotrexate were randomly assigned to 125 mg subcutaneous abatacept weekly or 40 mg subcutaneous adalimumab bi-weekly, both in combination with methotrexate in a two-year study.
The study group comprised 646 patients were randomized to receive either abatacept or adalimumab plus methotrexate; 86.2% of the patients who received abatacept and 82% of the patients who received adalimumab completed 12 months of therapy. At one year, 64.8% and 63.4% of patients, respectively, demonstrated an ACR20 response; the estimated difference between groups was 1.8, which demonstrated the non-inferiority of abatacept versus adalimumab. The investigators noted that all efficacy measures showed similar results and kinetics of response. Rates of radiographic (X-ray) non-progression were 84.8% and 88.6%. The incidence of serious adverse events was 10.1% and 9.1%; serious infections were 2.2% and 2.7%. Discontinuations due to adverse events were 3.1% versus 6.1%, due to serious adverse events were 1.3% versus 3%. Injection site reactions occurred in 3.8% versus 9.1%.
The authors concluded that “abatacept demonstrated comparable efficacy versus adalimumab with similar kinetics of response and inhibition of radiographic progression at 1 year. The safety was generally similar other than significantly more local injection site reactions with adalimumab.”
Abatacept (Orencia; Bristol Myers Squibb) reduces the pain, swelling, difficulty with daily activities, and joint damage caused by rheumatoid arthritis in patients who have not been helped by other medications. Abatacept is in a class of medications called selective costimulation modulators (immunomodulators). It works by blocking the activity of T-cells, a type of immune cell in the body that causes swelling and joint damage in people who have arthritis.
Adalimumab (Humira; Abbott) is recommended for moderate to severe rheumatoid arthritis in adults. Humira can be used alone, with methotrexate, or with certain other medicines. Humira may prevent further damage to bones and joints and may help one’s ability to perform daily activities. It is the third tumor necrosis factor (TNF) inhibitor, after infliximab and etanercept, to be approved in the United States.
Reference: Arthritis and Rheumatism