ABA versus HCQ in Palindromic Rheumatism Save
Palindromic rheumatism may develop rheumatoid arthritis (RA) and could be an at-risk population. An pilot trial compared abatacept (ABA) versus hydroxychloroquine and demonstrated ABA reduces RA development in a 2 year study.
An open-label, multicenter, randomized trial enrolled 70 patients with seropositive palindromic rheumatism (CCP+ or RF+) from 14 rheumatology centers in Spain. The primary outcome was the development of persistent (rheumatoid) arthritis. Secondary outcomes included the frequency of flares and adverse events.
The study favored ABA with RA developing in 21% of the 34 ABA patients versus 50% of the 36 HCQ patients during the 24 months of follow-up (P = 0.010). ABA had a significantly longer time to progression to RA vs. HCQ (hazard ratio 0.27; P = 0.0299). Abatacept also had reduced intensity of joint attacks (but no difference in frequency) and a higher frequency of symptom remission.
Neither therapy change autoantibody titers and both drugs were well tolerated.
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