An open-label trial of abatacept (CTLA4-IG) in non-severe relapsing granulomatosis with polyangiitis (Wegener's)

Carol A. Langford, Paul A. Monach, Ulrich Specks, Philip Seo, David Cuthbertson, Carol A. McAlear, Steven R Ytterberg, Gary S. Hoffman, Jeffrey P. Krischer, Peter A. Merkel

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Abstract

Objectives To determine the safety and efficacy of abatacept in non-severe relapsing granulomatosis with polyangiitis (Wegener's)(GPA). Methods An open-label trial of intravenous abatacept was conducted in 20 patients with non-severe relapsing GPA. Prednisone up to 30 mg daily was permitted within the first 2 months, and patients on methotrexate, azathioprine, or mycophenolate mofetil continued these agents. Patients remained on study until common closing or early termination. Results Of the 20 patients, 18 (90%) had disease improvement, 16 (80%) achieved remission (BVAS/ WG=0) at a median of 1.9 months, and 14 (70%) reached common closing. Six patients (30%) met criteria for early termination due to increased disease activity; 3 of 6 achieved remission and relapsed at a median of 8.6 months. The median duration of remission before common closing was 14.4 months, with the median duration of time on study for all patients being 12.3 months (range 2-35 months). Eleven of the 15 (73%) patients on prednisone reached 0 mg. Nine severe adverse events occurred in 7 patients, including 7 infections that were successfully treated. Conclusions In this study of patients with non-severe relapsing GPA, abatacept was well tolerated and was associated with a high frequency of disease remission and prednisone discontinuation.

Original languageEnglish (US)
Pages (from-to)1376-1379
Number of pages4
JournalAnnals of the Rheumatic Diseases
Volume73
Issue number7
DOIs
StatePublished - 2014

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Granulomatosis with Polyangiitis
Prednisone
Labels
Mycophenolic Acid
Azathioprine
Methotrexate
Abatacept
Safety

ASJC Scopus subject areas

  • Rheumatology
  • Immunology
  • Biochemistry, Genetics and Molecular Biology(all)
  • Immunology and Allergy

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An open-label trial of abatacept (CTLA4-IG) in non-severe relapsing granulomatosis with polyangiitis (Wegener's). / Langford, Carol A.; Monach, Paul A.; Specks, Ulrich; Seo, Philip; Cuthbertson, David; McAlear, Carol A.; Ytterberg, Steven R; Hoffman, Gary S.; Krischer, Jeffrey P.; Merkel, Peter A.

In: Annals of the Rheumatic Diseases, Vol. 73, No. 7, 2014, p. 1376-1379.

Research output: Contribution to journalArticle

Langford, CA, Monach, PA, Specks, U, Seo, P, Cuthbertson, D, McAlear, CA, Ytterberg, SR, Hoffman, GS, Krischer, JP & Merkel, PA 2014, 'An open-label trial of abatacept (CTLA4-IG) in non-severe relapsing granulomatosis with polyangiitis (Wegener's)', Annals of the Rheumatic Diseases, vol. 73, no. 7, pp. 1376-1379. https://doi.org/10.1136/annrheumdis-2013-204164
Langford, Carol A. ; Monach, Paul A. ; Specks, Ulrich ; Seo, Philip ; Cuthbertson, David ; McAlear, Carol A. ; Ytterberg, Steven R ; Hoffman, Gary S. ; Krischer, Jeffrey P. ; Merkel, Peter A. / An open-label trial of abatacept (CTLA4-IG) in non-severe relapsing granulomatosis with polyangiitis (Wegener's). In: Annals of the Rheumatic Diseases. 2014 ; Vol. 73, No. 7. pp. 1376-1379.
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AU - Seo, Philip

AU - Cuthbertson, David

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