title: Abatacept: a costimulatory inhibitor for treatment of rheumatoid arthritis.
abstract: T cell costimulation is believed to be crucial in orchestrating immune responses that lead to inflammation and destruction in rheumatoid arthritis (RA). Abatacept is a novel recombinant CTLA4Ig fusion protein that selectively modulates costimulation via interrupting the CD28:CD80/86 pathway, resulting in downregulation of T cell activation and multiple ensuing effector mechanisms. Abatacept has been shown to be efficacious, either when given alone or in combination with methotrexate, in patients with active RA, including anti-TNF failures. Improvements in clinical signs and symptoms, slowing of radiological progression, and enhancement in patient function and pain have been reported in clinical trials. Infusions were well-tolerated with a favourable safety profile similar to placebo and no appreciable immunogenicity. Abatacept is the first in a new class of biological response modifiers called costimulatory blockers.
authors.affiliation: Division of Clinical Immunology and Rheumatology, Department of Medicine, University of Alabama, 1717 6th Ave South, Birmingham, AL 35294-7201, USA.
authors.forename: Gim Gee
authors.initials: GG
authors.lastname: Teng
authors.forename: Anthony M
authors.initials: AM
authors.lastname: Turkiewicz
authors.forename: Larry W
authors.initials: LW
authors.lastname: Moreland
mesh_terms: D000069594:Abatacept; D000818:Animals; D018501:Antirheumatic Agents / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000276:immunology; D004195:Disease Models, Animal; D004359:Drug Therapy, Combination; D006801:Humans; D018796:Immunoconjugates / Q000008:administration & dosage / Q000493:pharmacokinetics* / Q000627:therapeutic use*; D007155:Immunologic Factors / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use*; D007262:Infusions, Intravenous; D008213:Lymphocyte Activation; D008727:Methotrexate / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D013601:T-Lymphocytes / Q000187:drug effects* / Q000276:immunology
chemical_list: D018501:Antirheumatic Agents; D018796:Immunoconjugates; D007155:Immunologic Factors; D000069594:Abatacept; D008727:Methotrexate