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The overlapping characteristics of rheumatoid arthritis and psoriatic arthritis (PsA) in terms of T-cell and macrophage infiltration and cytokine patterns suggest that targeted therapies could have a similar effect in both diseases.1 Tumour necrosis factor alpha (TNFα) blockers have shown efficacy in PsA, but a significant proportion of patients do not respond or are intolerant to these drugs.2 In these patients, agents blocking T-cell activation are a potential therapeutic option. Preliminary data have shown efficacy of abatacept in psoriasis vulgaris3 and spondyloarthropathy.4 However, data on the effects of abatacept in PsA are lacking. We describe the clinical and immunopathological effects of abatacept in a patient with PsA refractory to TNFα therapy.
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