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Abatacept may be helpful for patients with RA-associated Sjögren’s syndrome
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Patients with rheumatoid arthritis and secondary Sjögren’s syndrome may benefit from abatacept, which may be effective in treating symptoms of both conditions, according to recently published research.
In their observational, prospective open-label study, researchers enrolled 36 women who were at least 20 years of age and had both rheumatoid arthritis (RA) and secondary Sjögren’s syndrome (SS). Patients with contraindications to abatacept, such as infection or pregnancy, were excluded.
For 52 weeks, patients received weight-adapted doses of IV abatacept at weeks 0, 2 and 4 and every 4 weeks thereafter. Concomitant use of corticosteroids was present in 17 patients.
Patients were evaluated for RA disease activity using the simplified disease activity index (SDAI), pain on a VAS, swollen and tender joint count, disease activity score and laboratory measures, such as C-reactive protein, erythrocyte sedimentation level and rheumatoid factor. Assessments were made at weeks 0, 4, 12, 24 and 52. Symptoms of SS were evaluated using a VAS for dry mouth and eyes and keratoconjunctive sicca. Saliva volume was assessed by Saxon’s test, and tear volume was measured by Schirmer’s test. Anti-SS-A and anti-SS-B antibodies and serum immunoglobulin G were measured at weeks 0, 12 and 24, and MRI of the parotid gland was performed at weeks 0 and 52. Adverse events were recorded at each visit.
Disease activity decreased according to SDAI after 4 weeks, but a modest reduction was observed in patients who did not use methotrexate concomitantly. Clinical remission was observed in 12 patients at 52 weeks. Of 26 patients with moderate or high disease activity based on SDAI, this figure was reduced to 13 patients.
Values for dry mouth and eye on a VAS decreased from over the study period, but parotid pain was not reduced. Based on Saxon’s test, saliva increased from 2136 mg/2 min at week 0 to 2397 mg/2 min at week 24. Investigators found tear volume was higher by Schirmer’s test at week 24, with an improvement from 4.2 mm/5 min to 6.4 mm/5 min. No correlations were observed between SDAI and volumes of saliva or tears.
Disclosures: The researchers report the work was supported by Health and Labour Research Grants. Please see the full study for a list of all other authors’ relevant financial disclosures.
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