Abatacept in the long-term treatment of rheumatoid arthritis

The last decade has been an era of exciting and innovative therapeutic targets in the treatment of moderate-to-severe rheumatoid arthritis. One such treatment that acts by disrupting T-cell activation is abatacept, which is currently used in patients who have had an inadequate clinical response to traditional disease-modifying drugs or anti-TNF therapies. As newer therapies emerge, issues that need addressing include: long-term drug tolerance, adverse events, sustained clinical response, prevention of progression in structural damage and retention rates. In this article we discuss a recently published paper by Kremer et al. that reported 3-year data on safety, efficacy and radiographic progression in patients enrolled in a clinical trial of abatacept, as well as the advantages and limitations of long-term extension studies.