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This article is part of the supplement: Co-stimulation blockade: from bench to bedside

Review

Abatacept in the treatment of rheumatoid arthritis

Maya H Buch, Edward M Vital and Paul Emery*

Author Affiliations

Academic Unit of Musculoskeletal Disease, University of Leeds, Chapeltown Road, Leeds, LS7 4SA, UK

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Arthritis Research & Therapy 2008, 10(Suppl 1):S5  doi:10.1186/ar2416

Published: 15 October 2008

Abstract

T-cell biology has regained importance in the pathogenesis of rheumatoid arthritis. Despite the significant improvements associated with the introduction of tumor necrosis factor-α blockade, reasonable proportions of failures and suboptimal responses have been reported, necessitating a search for alternative targeted therapies. This has included drug therapy designed to interrupt T-cell activation via the co-stimulation pathway. Abatacept is a recombinant fusion protein that blocks the co-stimulatory signal mediated by the CD28-CD80/86 pathway, which is required for T-cell activation. Several clinical trials have confirmed the safety and efficacy of this drug in the treatment of rheumatoid arthritis. This review summarizes the clinical data supporting this line of treatment and considers the safety and efficacy data from phase II and III trials.