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Therapeutic intervention with abatacept is feasible for patients at risk for rheumatoid arthritis, according to a study published online Feb. 13 in The Lancet.

Andrew P. Cope, M.D., from King’s College London, and colleagues conducted a multicenter trial involving patients at risk for rheumatoid arthritis with serum antibodies to citrullinated protein antigens and rheumatoid factor with inflammatory joint pain. Participants were randomly assigned (1:1) to 125-mg abatacept subcutaneous injections on a weekly basis or placebo for 12 months (110 and 103, respectively) and were then followed for 12 months.

The researchers found that the primary end point (time to development of clinical synovitis in three or more joints or rheumatoid arthritis according to the American College of Rheumatology and European Alliance of Associations for Rheumatology 2010 criteria, whichever was met first) was met by 6 and 29 percent of patients in the abatacept and placebo groups, respectively, during the treatment period. At 24 months, 25 percent of participants in the abatacept group and 37 percent in the placebo group had progressed to rheumatoid arthritis. At 12 months, the estimated proportion remaining arthritis-free was 92.8 and 69.2 percent, respectively. Over 24 months, Kaplan-Meier arthritis-free survival plots favored abatacept. Compared with placebo, abatacept was associated with improvements in pain scores, functional well-being, and quality-of-life measurements during treatment, as well as low scores of subclinical synovitis by ultrasonography.

“Treatment of adults at high risk of developing rheumatoid arthritis with abatacept reduces progression to clinically apparent arthritis during the treatment phase,” the authors write.

Several authors disclosed ties to Bristol Myers Squibb, which manufactures abatacept and funded the study.

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