A critical evaluation of the role of subcutaneous abatacept in the treatment of rheumatoid arthritis: patient considerations

There are now more therapeutic options for the treatment of rheumatoid arthritis (RA) than ever before, involving a range of mechanisms of action and different routes of administration. The T-cell costimulation modulator abatacept is the first biologic therapy for RA to be available in both subcutan...

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Main Authors:	Wells, Alvin F, Jodat, Nicole, Schiff, Michael
Format:	Online
Language:	English
Published:	Dove Medical Press 2014
Online Access:	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3933241/

id	pubmed-3933241
recordtype	oai_dc
spelling	pubmed-39332412014-03-05 A critical evaluation of the role of subcutaneous abatacept in the treatment of rheumatoid arthritis: patient considerations Wells, Alvin F Jodat, Nicole Schiff, Michael Review There are now more therapeutic options for the treatment of rheumatoid arthritis (RA) than ever before, involving a range of mechanisms of action and different routes of administration. The T-cell costimulation modulator abatacept is the first biologic therapy for RA to be available in both subcutaneous (SC) and intravenous (IV) formulations. This review evaluates the utility of SC abatacept, with a particular focus on patient-reported outcomes, including physical function, pain, fatigue, and quality of life. Practical questions relating to the clinical use of SC abatacept are also addressed, including the relevance of abatacept’s mechanism of action; whether IV and SC abatacept are comparable; if patients can easily switch from IV to SC abatacept; whether an IV loading dose is needed; and if temporary treatment interruptions or lack of concomitant methotrexate can affect efficacy or safety. Topics that are of particular concern to patients when using SC biologics, such as injection-site reactions, are also discussed. Observational data from registries and meta-analyses of clinical studies suggest comparable clinical efficacy between biologic disease-modifying antirheumatic drugs; however, such analyses rarely focus on key determinants of patient quality of life such as pain, fatigue, and physical function. The head-to-head AMPLE study is one of the first studies powered to directly compare two biologics in patients with RA. Patient-reported outcomes from year 1 of the ongoing study are evaluated, demonstrating comparable improvements in physical function, pain, fatigue, Short Form-36 Health Survey, and Routine Assessment of Patient Index Data 3 scores between SC abatacept and SC adalimumab when administered with concomitant methotrexate. In summary, the data presented herein show that the SC formulation of abatacept provides a valuable addition to the range of available therapy options for patients with RA, capable of significantly improving key patient considerations such as pain, disability, loss of function, fatigue, and quality of life. Dove Medical Press 2014-02-17 /pmc/articles/PMC3933241/ /pubmed/24600202 http://dx.doi.org/10.2147/BTT.S55783 Text en © 2014 Wells et al. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
repository_type	Open Access Journal
institution_category	Foreign Institution
institution	US National Center for Biotechnology Information
building	NCBI PubMed
collection	Online Access
language	English
format	Online
author	Wells, Alvin F Jodat, Nicole Schiff, Michael
spellingShingle	Wells, Alvin F Jodat, Nicole Schiff, Michael A critical evaluation of the role of subcutaneous abatacept in the treatment of rheumatoid arthritis: patient considerations
author_facet	Wells, Alvin F Jodat, Nicole Schiff, Michael
author_sort	Wells, Alvin F
title	A critical evaluation of the role of subcutaneous abatacept in the treatment of rheumatoid arthritis: patient considerations
title_short	A critical evaluation of the role of subcutaneous abatacept in the treatment of rheumatoid arthritis: patient considerations
title_full	A critical evaluation of the role of subcutaneous abatacept in the treatment of rheumatoid arthritis: patient considerations
title_fullStr	A critical evaluation of the role of subcutaneous abatacept in the treatment of rheumatoid arthritis: patient considerations
title_full_unstemmed	A critical evaluation of the role of subcutaneous abatacept in the treatment of rheumatoid arthritis: patient considerations
title_sort	critical evaluation of the role of subcutaneous abatacept in the treatment of rheumatoid arthritis: patient considerations
description	There are now more therapeutic options for the treatment of rheumatoid arthritis (RA) than ever before, involving a range of mechanisms of action and different routes of administration. The T-cell costimulation modulator abatacept is the first biologic therapy for RA to be available in both subcutaneous (SC) and intravenous (IV) formulations. This review evaluates the utility of SC abatacept, with a particular focus on patient-reported outcomes, including physical function, pain, fatigue, and quality of life. Practical questions relating to the clinical use of SC abatacept are also addressed, including the relevance of abatacept’s mechanism of action; whether IV and SC abatacept are comparable; if patients can easily switch from IV to SC abatacept; whether an IV loading dose is needed; and if temporary treatment interruptions or lack of concomitant methotrexate can affect efficacy or safety. Topics that are of particular concern to patients when using SC biologics, such as injection-site reactions, are also discussed. Observational data from registries and meta-analyses of clinical studies suggest comparable clinical efficacy between biologic disease-modifying antirheumatic drugs; however, such analyses rarely focus on key determinants of patient quality of life such as pain, fatigue, and physical function. The head-to-head AMPLE study is one of the first studies powered to directly compare two biologics in patients with RA. Patient-reported outcomes from year 1 of the ongoing study are evaluated, demonstrating comparable improvements in physical function, pain, fatigue, Short Form-36 Health Survey, and Routine Assessment of Patient Index Data 3 scores between SC abatacept and SC adalimumab when administered with concomitant methotrexate. In summary, the data presented herein show that the SC formulation of abatacept provides a valuable addition to the range of available therapy options for patients with RA, capable of significantly improving key patient considerations such as pain, disability, loss of function, fatigue, and quality of life.
publisher	Dove Medical Press
publishDate	2014
url	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3933241/
_version_	1612061353647800320

A critical evaluation of the role of subcutaneous abatacept in the treatment of rheumatoid arthritis: patient considerations

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