Abatacept and arthritis

by Nathan Wei, MD, FACP, FACR

Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.

Click here: Second Opinion Arthritis Treatment Kit

This article was adapted from an excellent review of Orencia. Unfortunately, I don't have the contact information for the author.

Abatacept (CTLA4–Ig) is a novel fusion protein designed to modulate the T cell co-stimulatory signal mediated through the CD28–CD80/86 pathway. In other words, it blocks the ability of the antigen presenting cell to interact fully with the T-cell.Clinical trials showed this compound was effective in the treatment of rheumatoid arthritis.

The failure of anti-TNF drugs to control disease in all patients has led to a search for other approaches to reduce disease activity. T cells are the most abundant inflammatory cells in the RA joint. However, previous treatments involving depletion of peripheral CD4+ T cells, have been less than successful. In contrast to depletion, it is possible that modulation of T cell function, possibly by targeting co-stimulatory molecules, was developed and shown to be effective at controlling the clinical signs and symptoms of RA.

Activation of T cells requires two distinct signals. The first is an antigen-specific interaction between the T cell receptor and antigen presented with the major histocompatibility complex (MHC) on the surface of an antigen-presenting cell. The second signal is provided through a number of different co-stimulatory molecules, an example of which is CD28.

Co-stimulation is especially important for T cell response, and its effects are governed by promoting cell proliferation and survival. Theoretically then, therapies targeting co-stimulatory signals have the potential to target specific T cell responses. Such an approach would be potentially useful in RA.

Abatacept, the fusion protein combining the extracellular portion of human CTLA4 T cell receptor and a blocking antibody, IgG1 Fc, has clearly been shown to be effective at controlling the signs and symptoms of RA, particularly at a dose of 10 mg/kg given monthly. The 2 mg/kg dose has not been shown to be as consistently effective.

Abatacept (Orencia) was approved for use in rheumatoid arthritis by the FDA in January 2006.

Get more information about abatacept and arthritis and related issues as well as...

• Insider arthritis tips that help you erase the pain and fatigue of rheumatoid arthritis almost overnight!

• Devastating ammunition against low back pain... discover 9 secrets!

• Ignored remedies that eliminate fibromyalgia symptoms quickly!

• Obsolete treatments for knee osteoarthritis that still are used... and may still work for you!

• The stiff penalties you face if you ignore this type of hip pain...

• 7 easy-to-implement neck pain remedies that work like a charm!

• And much more...

Click here Second Opinion Arthritis Treatment Kit

Return to arthritis home page.

Copyright (c) 2004 Arthritis-Treatment-and-Relief.com - All Rights Reserved

How to Beat Arthritis! Get our FREE monthly Ezine and get your life back!

Enter your E-mail Address
Enter your First Name (optional)

Don't worry — your e-mail address is totally secure.
I promise to use it only to send you Insider Arthritis Tips.