Long-term safety, efficacy, and quality of life in patients with juvenile idiopathic arthritis treated with intravenous abatacept for up to seven years.

Abstract

OBJECTIVE:

The efficacy and safety of abatacept in patients with juvenile idiopathic arthritis (JIA) who experienced an inadequate response to disease-modifying antirheumatic drugs were previously established in a phase III study that included a 4-month open-label lead-in period, a 6-month double-blind withdrawal period, and a long-term extension (LTE) phase. The aim of this study was to present the safety, efficacy, and patient-reported outcomes of abatacept treatment (10 mg/kg every 4 weeks) during the LTE phase, for up to 7 years of followup.

METHODS:

Patients enrolled in the phase III trial could enter the open-label LTE phase if they had not achieved a response to treatment at month 4 or if they had received abatacept or placebo during the double-blind period.

RESULTS:

One hundred fifty-three (80.5%) of 190 patients entered the LTE phase, and 69 patients (36.3%) completed it. The overall incidence rate (events per 100 patient-years) of adverse events decreased during the LTE phase (433.61 events during the short-term phase [combined lead-in and double-blind periods] versus 132.39 events during the LTE phase). Similar results were observed for serious adverse events (6.82 versus 5.60), serious infections (1.13 versus 1.72), malignancies (1.12 versus 0), and autoimmune events (2.26 versus 1.18). American College of Rheumatology (ACR) Pediatric 30 (Pedi 30) responses, Pedi 70 responses, and clinically inactive disease status were maintained throughout the LTE phase in patients who continued to receive therapy. Improvements in the Child Health Questionnaire physical and psychosocial summary scores were maintained over time.

CONCLUSION:

Long-term abatacept treatment for up to 7 years was associated with consistent safety, sustained efficacy, and quality-of-life benefits in patients with JIA.

• Authors: Daniel J Lovell, Nicolino Ruperto, Richard Mouy, Eliana Paz, Nadina Rubio-Pérez, Clovis A Silva, Carlos Abud-Mendoza, Ruben Burgos-Vargas, Valeria Gerloni, Jose A Melo-Gomes, Claudia Saad-Magalhaes, J Chavez-Corrales, Christian Huemer, Alan Kivitz, Francisco J Blanco, Ivan Foeldvari, Michael Hofer, Hans-Iko Huppertz, Chantal Job Deslandre, Kirsten Minden, Marilynn Punaro, Alan J Block, Edward H Giannini, Alberto Martini, Pediatric Rheumatology Collaborative Study Group and the Paediatric Rheumatology International Trials Organisation
• Journal: Arthritis & rheumatology (Hoboken, N.J.) (Arthritis Rheumatol) Vol. 67 Issue 10 Pg. 2759-70 (Oct 2015) ISSN: 2326-5205 [Electronic] United States
• PMID: 26097215 (Publication Type: Clinical Trial, Phase III, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: © 2015 The Authors. Arthritis & Rheumatology is published by Wiley Periodicals, Inc. on behalf of the American College of Rheumatology.

Chemical References

• Antirheumatic Agents
• Abatacept

Topics

• Abatacept (adverse effects, therapeutic use)
• Activities of Daily Living (psychology)
• Adolescent
• Antirheumatic Agents (adverse effects, therapeutic use)
• Arthritis, Juvenile (drug therapy, psychology)
• Child
• Double-Blind Method
• Female
• Humans
• Longitudinal Studies
• Male
• Psychology
• Quality of Life (psychology)
• Self Report
• Surveys and Questionnaires
• Time Factors
• Treatment Outcome