title: Abatacept inhibits progression of structural damage in rheumatoid arthritis: results from the long-term extension of the AIM trial.
abstract: OBJECTIVE
  Assess the effect of abatacept on progression of structural damage over 2 years in patients with rheumatoid arthritis who had an inadequate response to methotrexate.
  
  
  METHODS
  539 patients entered an open-label extension of the AIM (Abatacept in Inadequate responders to Methotrexate) trial and received abatacept. Radiographic assessment of the hands and feet was performed at baseline, year 1 and year 2. At year 2, each patient's radiographs were scored for progression blinded to sequence and treatment allocation.
  
  
  RESULTS
  In patients treated with abatacept for 2 years, greater reduction in progression of structural damage was observed in year 2 than in year 1. The mean change in total Genant-modified Sharp scores was reduced from 1.07 units in year 1 to 0.46 units in year 2. Similar reductions were observed in erosion and joint space narrowing scores. Following 2 years of treatment with abatacept, 50% of patients had no progression of structural damage as defined by a change in the total score of < or =0 compared with baseline. 56% of patients treated with abatacept had no progression during the first year compared with 45% of patients treated with placebo. In their second year of treatment with abatacept, more patients had no progression than in the first year (66% vs 56%).
  
  
  CONCLUSIONS
  Abatacept has a sustained effect that inhibits progression of structural damage. Furthermore, the mean change in radiographic progression in patients treated with abatacept for 2 years was significantly lower in year 2 versus year 1, suggesting that abatacept may have an increasing disease-modifying effect on structural damage over time.
authors: University of California, San Francisco, San Francisco, CA, USA. harry.genant@ucsf.edu
authors: H K
authors: HK
authors: Genant
authors: C G
authors: CG
authors: Peterfy
authors: R
authors: R
authors: Westhovens
authors: J-C
authors: JC
authors: Becker
authors: R
authors: R
authors: Aranda
authors: G
authors: G
authors: Vratsanos
authors: J
authors: J
authors: Teng
authors: J M
authors: JM
authors: Kremer
mesh_terms: D000069594:Abatacept; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging / Q000188:drug therapy*; D018450:Disease Progression; D005384:Finger Joint / Q000000981:diagnostic imaging; D005500:Follow-Up Studies; D033023:Foot Joints / Q000000981:diagnostic imaging; D006801:Humans; D018796:Immunoconjugates / Q000627:therapeutic use*; D011859:Radiography; D016032:Randomized Controlled Trials as Topic
chemical_list: D018501:Antirheumatic Agents; D018796:Immunoconjugates; D000069594:Abatacept