Abatacept improves both the physical and mental health of patients with
rheumatoid arthritis who have inadequate response to methotrexate treatment.
Author(s): Russell AS, Wallenstein GV, Li T, Martin MC, Maclean R, Blaisdell B, Gajria K,
Cole JC, Becker JC, Emery P.
Affiliation(s): 562 Heritage Medical Research Centre, University of Alberta, Edmonton, AB, T6G
2S2 Canada. asr@gpu.srv.ualberta.ca
Publication date & source: 2007, Ann Rheum Dis. , 66(2):189-94
OBJECTIVE: To examine the impact of added abatacept treatment on health related
quality of life (HRQoL) in patients with rheumatoid arthritis (RA) who have
inadequate response to methotrexate (MTX).
METHODS: The impact of abatacept treatment on HRQoL was examined in a
longitudinal, randomised double blind, placebo controlled clinical trial. Effects
of treatment on HRQoL were examined using repeated measures analysis of
covariance and comparing rates of change in HRQoL across treatment groups. The
relationship between American College of Rheumatology (ACR) clinical markers and
disease duration with changes in HRQoL indicators was also examined. Finally, a
responder analysis was used to examine the percentage of patients who improved by
0.5 SD in 12 months or who reached the normative levels seen in the US general
population.
RESULTS: Statistically significant improvements in the abatacept group relative
to controls were observed across a range of HRQoL measures, including physical
function, fatigue, all eight domains of the SF-36, and the physical and mental
component summaries (PCS and MCS). Improvements were seen as early as day 29 for
fatigue and for five out of eight SF-36 domains. By day 169, all HRQoL measures
were significantly better with abatacept than with placebo. HRQoL gains were
associated with greater ACR clinical improvement, and the effects were consistent
for patients with different disease duration. A significantly greater percentage
of patients treated with abatacept reached normative levels of PCS, MCS, physical
functioning, and fatigue compared with patients treated with MTX alone.
CONCLUSION: Combined abatacept and MTX treatment produces significant
improvements across a wide range of HRQoL domains in patients with RA.
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