PT  - JOURNAL ARTICLE
AU  - H K Genant
AU  - C G Peterfy
AU  - R Westhovens
AU  - J-C Becker
AU  - R Aranda
AU  - G Vratsanos
AU  - J Teng
AU  - J M Kremer
TI  - Abatacept inhibits progression of structural damage in rheumatoid arthritis: results from the long-term extension of the AIM trial
AID  - 10.1136/ard.2007.085084
DP  - 2008 Aug 01
TA  - Annals of the Rheumatic Diseases
PG  - 1084--1089
VI  - 67
IP  - 8
4099  - http://ard.bmj.com/content/67/8/1084.short
4100  - http://ard.bmj.com/content/67/8/1084.full
SO  - Ann Rheum Dis2008 Aug 01; 67
AB  - Objective: Assess the effect of abatacept on progression of structural damage over 2 years in patients with rheumatoid arthritis who had an inadequate response to methotrexate.Methods: 539 patients entered an open-label extension of the AIM (Abatacept in Inadequate responders to Methotrexate) trial and received abatacept. Radiographic assessment of the hands and feet was performed at baseline, year 1 and year 2. At year 2, each patient’s radiographs were scored for progression blinded to sequence and treatment allocation.Results: In patients treated with abatacept for 2 years, greater reduction in progression of structural damage was observed in year 2 than in year 1. The mean change in total Genant-modified Sharp scores was reduced from 1.07 units in year 1 to 0.46 units in year 2. Similar reductions were observed in erosion and joint space narrowing scores. Following 2 years of treatment with abatacept, 50% of patients had no progression of structural damage as defined by a change in the total score of ⩽0 compared with baseline. 56% of patients treated with abatacept had no progression during the first year compared with 45% of patients treated with placebo. In their second year of treatment with abatacept, more patients had no progression than in the first year (66% vs 56%).Conclusions: Abatacept has a sustained effect that inhibits progression of structural damage. Furthermore, the mean change in radiographic progression in patients treated with abatacept for 2 years was significantly lower in year 2 versus year 1, suggesting that abatacept may have an increasing disease-modifying effect on structural damage over time.