Abatacept Efficacy Giant Cell Arteritis Save

This appears to be the year for biologic treatments in giant cell artertis (GCA).

A novel trial from Dr. Carol Langford and colleagues has reported the results of a 49 patient trial of newly-diagnosed or relapsing GCA where all patients were treated with abatacept 10 mg/kg IV on days 1, 15, 29, week 8, together with prednisone.

At week 12, those in remission underwent a double-blinded randomization to either placebo or continued monthly abatacept. The primary endpoint was duration of remission (relapse-free survival). 

Full 12 week therapy was achieved by 41 patients and underwent a blinded randomization to abatacept or placebo.  Prednisone was tapered and discontinued in all patients at week 28.

The relapse-free survival at 12 months was 48% for those receiving abatacept and 31% for those receiving placebo (p=0.049).  Remission was longer in those on abatacept (9.9 months) compared to placebo (3.9 months, p=0.023).

There were no differences in safety between the 2 arms. 

Abatacept was effective in some with GCA. Although the safety profile was encouraging, treatment success appears to be less than that seen in the GiACTA trial with tocilizumab.