Abatacept Evaluated for Giant Cell Arteritis

Giant cell arteritis is effectively treated with glucocorticoids, but they have side effects and patients tend to relapse. Researchers evaluated abatacept combined with prednisone and saw fewer relapses.

Adding abatacept to a standard treatment regimen with prednisone reduced the risk of relapse of vasculitis in patients with giant cell arteritis (GCA) researchers reported. In an abstract presented at the 2015 American College of Rheumatology Annual Meeting in San Francisco, CA, Carol Langford of the University of Pennsylvania in Philadelphia, PA, and colleagues at other institutions said they evaluated patients with newly diagnosed or relapsing GCA.

The condition is large-vessel primary systemic vasculitis. T-cell activation may play a role in its onset. The researchers got abatacept (Orencia/Bristol-Myers-Squibb) over a period of two months, a total of 4 doses. They also got prednisone. At 12 weeks, patients who were in remission were randomized to the drug treatment or placebo.

In all 49 patients with GCA got the study drug and 41 reached the week 12 randomization.

Relapse-free survival at 12 months was estimated to be 48% for those who got the drug and 31% for those on placebo.

Patients who got the drug had longer periods of remission (9.9 months vs. 3.9months for placebo).

There were adverse events, but "there was no difference in the frequency or severity of adverse events between treatment arms, including the rate of infection," they noted.

The drug regimen with abatacept and prednisone "reduced the risk of relapse of vasculitis and was not associated with a higher rate of toxicity compared to prednisone alone," they concluded. The group said the study "provides the first trial-level evidence of a targeted immunomodulatory therapy that has demonstrated efficacy for the treatment of GCA."

They will present their findings on Nov. 10.