Abatacept
In the pivotal double-blind, phase 3 trial involving 424 psoriatic arthritis patients, roughly 60% with prior exposure to a tumor necrosis factor inhibitor and 60% on concomitant methotrexate, the proportion of patients with at least 20% improvement in the American College of Rheumatology criteria (ACR20) was 39.4% in patients on the selective T-cell costimulation modulator, compared with 22.3% among placebo-treated controls. The benefit on psoriasis lesions was modest, and there was no significant difference between the two study arms in terms of Health Assessment Questionnaire-Disability Index response rates (Ann Rheum Dis. 2017 Sep;76[9]:1550-8).
“It works reasonably well on joint disease. It’s not as good as some of the other options,” commented Dr. Ruderman, professor of medicine and associated chief for clinical affairs in the division of rheumatology at Northwestern University, Chicago.“I think we could say the effect is modest,” Dr. Kavanaugh said. “The challenge to us still is to identify patients who are going to have a good response, likely the patients with more joint than skin symptoms.”
An attractive feature of the drug is that its safety profile is well known as a result of its extensive track record in treating RA, he added.