Selective costimulation modulation with abatacept: a look at quality-of-life outcomes in patients with rheumatoid arthritis.
OBJECTIVES: To highlight the importance of improving quality of life (QoL) in patients with rheumatoid arthritis (RA) and to provide a summary of the QoL benefits provided by abatacept in patients who have an inadequate response to disease-modifying antirheumatic drugs (DMARDs) and/or tumor necrosis factor (TNF) antagonists. METHODS: A literature search of the MEDLINE, EMBASE, and BIOSIS databases was performed using the terms "abatacept," "cytotoxic T-lymphocyte-associated antigen-4 (CTLA-4)" and "ORENCIA," with the coindexing terms: "abatacept," "CTLA-4," and "ORENCIA." Only articles presenting primary data on QoL outcomes from randomized, placebo-controlled clinical trials of abatacept were included in the review. RESULTS: The literature search initially yielded 220 articles. A total of 8 articles fulfilled the inclusion criteria described above and are reviewed here. In clinical trials to date, abatacept treatment has been shown to improve QoL in patients who have an inadequate response to traditional DMARDs and TNF antagonists. CONCLUSIONS: Improvements in QoL are rated by patients as 1 of the most important benefits of an effective treatment; however, inclusion of QoL measurements in clinical trials as a measure of efficacy is a relatively recent event. Abatacept has been shown to alleviate both the physical and the emotional/social burdens that RA imposes on the patient, including improvements in day-to-day activity and reducing sleep problems and fatigue in patients with RA who have an inadequate response to DMARDs and/or TNF antagonists.
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