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

Alvin F Wells,1,2 Nicole Jodat,1 Michael Schiff3 1Rheumatology and Immunotherapy Center, Franklin, WI, USA; 2Duke University Medical Center, Durham, NC, USA; 3University of Colorado, School of Medicine, Denver, CO, USA Abstract: There are now more therapeutic options for the treatment of rheumato...

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Autores principales:	Wells AF, Jodat N, Schiff M
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2014
Materias:	Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/d75d2e61e6324effb24702585f8df838
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spelling	oai:doaj.org-article:d75d2e61e6324effb24702585f8df8382021-12-02T07:34:24ZA critical evaluation of the role of subcutaneous abatacept in the treatment of rheumatoid arthritis: patient considerations1177-5475https://doaj.org/article/d75d2e61e6324effb24702585f8df8382014-02-01T00:00:00Zhttp://www.dovepress.com/a-critical-evaluation-of-the-role-of-subcutaneous-abatacept-in-the-tre-a15833https://doaj.org/toc/1177-5475 Alvin F Wells,1,2 Nicole Jodat,1 Michael Schiff3 1Rheumatology and Immunotherapy Center, Franklin, WI, USA; 2Duke University Medical Center, Durham, NC, USA; 3University of Colorado, School of Medicine, Denver, CO, USA Abstract: 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. Keywords: rheumatoid arthritis, abatacept, subcutaneous, biologic DMARD, patient-reported outcomesWells AFJodat NSchiff MDove Medical PressarticleMedicine (General)R5-920ENBiologics: Targets & Therapy, Vol 2014, Iss default, Pp 41-55 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine (General) R5-920
spellingShingle	Medicine (General) R5-920 Wells AF Jodat N Schiff M A critical evaluation of the role of subcutaneous abatacept in the treatment of rheumatoid arthritis: patient considerations
description	Alvin F Wells,1,2 Nicole Jodat,1 Michael Schiff3 1Rheumatology and Immunotherapy Center, Franklin, WI, USA; 2Duke University Medical Center, Durham, NC, USA; 3University of Colorado, School of Medicine, Denver, CO, USA Abstract: 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. Keywords: rheumatoid arthritis, abatacept, subcutaneous, biologic DMARD, patient-reported outcomes
format	article
author	Wells AF Jodat N Schiff M
author_facet	Wells AF Jodat N Schiff M
author_sort	Wells AF
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
publisher	Dove Medical Press
publishDate	2014
url	https://doaj.org/article/d75d2e61e6324effb24702585f8df838
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A critical evaluation of the role of subcutaneous abatacept in the treatment of rheumatoid arthritis: patient considerations

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