title: Clinical response and tolerability to abatacept in patients with rheumatoid arthritis previously treated with infliximab or abatacept: open-label extension of the ATTEST Study.
abstract: OBJECTIVE
  To assess the efficacy and safety of abatacept in biological-naive patients with rheumatoid arthritis and an inadequate response to methotrexate treated in the long-term extension (LTE) of the ATTEST trial.
  
  
  METHODS
  Patients randomly assigned to abatacept, placebo or infliximab completing the 1-year double-blind period were eligible to receive abatacept ∼10 mg/kg in the open-label LTE. Efficacy to year 2 is presented for patients randomly assigned to abatacept or infliximab who switched to open-label abatacept. Safety data are presented for all patients entering LTE regardless of double-blind treatment.
  
  
  RESULTS
  Of 431 patients randomly assigned, 79.8% remained on abatacept at year 2. At years 1 and 2, 19.7% and 26.1% of abatacept and 13.3% and 28.6% of infliximab-to-abatacept patients achieved disease activity score 28-defined remission (<2.6). Safety with abatacept during the cumulative study period was consistent with the double-blind experience, with no increase in adverse event incidence following the switch to abatacept.
  
  
  CONCLUSIONS
  In methotrexate-inadequate responders, abatacept efficacy was maintained over 2 years. For infliximab-to-abatacept patients, efficacy improvements were seen in year 2 after patients switched to abatacept. Switching directly from infliximab to abatacept was well tolerated. These data demonstrate that abatacept provides sustained responses and consistent safety, suggesting that switching from infliximab to abatacept is a viable treatment option.
authors.affiliation: Department of Rheumatology, University of Colorado, 5400 South Monaco Street, Greenwood Village, CO 80111, USA. lmschiff@aol.com
authors.forename: Michael
authors.initials: M
authors.lastname: Schiff
authors.forename: Mauro
authors.initials: M
authors.lastname: Keiserman
authors.forename: Christine
authors.initials: C
authors.lastname: Codding
authors.forename: Suthin
authors.initials: S
authors.lastname: Songcharoen
authors.forename: Alberto
authors.initials: A
authors.lastname: Berman
authors.forename: Sauithree
authors.initials: S
authors.lastname: Nayiager
authors.forename: Cristina
authors.initials: C
authors.lastname: Saldate
authors.forename: Richard
authors.initials: R
authors.lastname: Aranda
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Becker
authors.forename: Marleen
authors.initials: M
authors.lastname: Nys
authors.forename: Manuela
authors.initials: M
authors.lastname: le Bars
authors.forename: Diane Moniz
authors.initials: DM
authors.lastname: Reed
authors.forename: Coralie
authors.initials: C
authors.lastname: Poncet
authors.forename: Maxime
authors.initials: M
authors.lastname: Dougados
mesh_terms: D000069594:Abatacept; D000328:Adult; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D004311:Double-Blind Method; D057915:Drug Substitution; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D018796:Immunoconjugates / Q000009:adverse effects / Q000627:therapeutic use*; D000069285:Infliximab; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; D018796:Immunoconjugates; D014409:Tumor Necrosis Factor-alpha; D000069594:Abatacept; D000069285:Infliximab; D008727:Methotrexate