Abatacept

Clinical trials are investigating Abatacept in several diseases, including rheumatoid arthritis, IgG4-related disease, giant cell arteritis, COVID-19, and juvenile idiopathic arthritis. These studies look at safety, effectiveness, remission, and whether Abatacept can help guide treatment choices in different patient groups.

Table of contents

Clinical trials overview

The trial data show that Abatacept is being studied in several interventional trials, mostly in rheumatoid arthritis, but also in IgG4-related disease, giant cell arteritis, COVID-19, and juvenile idiopathic arthritis.[1][2][3][4][5][6][7][8][9][10][11][12][13]

Most of these studies are in Phase 3, which means they are larger trials that compare treatments and measure how well they work in real patient groups.[3][4][5][6][7][8][9][10][11][12][13][2]

The studies are designed to test safety, efficacy (how well a treatment works), remission, relapse prevention, and whether certain markers can help predict who will respond best.[1][2][3][4][5][6][7][8][9][10][11][12][13]

Rheumatoid arthritis studies

Rheumatoid arthritis is the main condition studied in the trial set, with multiple trials in early disease, moderate to severe disease, and treatment-resistant disease.[1][3][6][7][8][9][10][13]

One Phase 1 study is looking at a combination approach in ACPA-positive rheumatoid arthritis, meaning patients have a specific antibody linked to the disease, and it measures safety events such as injection-related reactions and changes in ACPA status over 12 weeks.[1]

Several Phase 3 trials focus on whether Abatacept can improve disease control in people with early rheumatoid arthritis, including patients who are seropositive (RF+ and ACPA+) and those with specific genetic risk markers.[6][3]

These trials measure outcomes such as remission, ACR50 response (a 50% improvement score used in arthritis research), CDAI (a clinical disease activity score), DAS28-CRP (a disease activity score using joint counts and a blood marker), and radiographic progression, which means joint damage seen on imaging over time.[3][6][7][8][9]

Some studies compare Abatacept with other active treatments, such as adalimumab or tocilizumab, while others compare treatment strategies, such as using Abatacept after a first TNF inhibitor or testing whether certain tissue biomarkers can predict response.[6][7][8][9]

One trial also studies a proposed Abatacept biosimilar, meaning a medicine designed to be highly similar to the original product, and compares efficacy, safety, and immunogenicity, which is the body’s immune response to the treatment.[8]

Studies in other conditions

In IgG4-related disease, a Phase 2 trial is testing whether Abatacept can reduce disease recurrence over 48 weeks compared with placebo, which is an inactive treatment used as a comparison.[2]

In giant cell arteritis, a randomized, double-blind, placebo-controlled Phase 3 study is measuring the proportion of patients in remission at Month 12.[4]

In hospitalized adults with COVID-19, Abatacept was studied in a large Phase 3 platform trial called STRIVE, where the main outcome was the Days to Recovery Scale over 60 days, a recovery measure that also includes not-recovered status and death.[5]

In children and adolescents with juvenile idiopathic arthritis, Abatacept appears in trials that study drug withdrawal strategies after remission and compare treatment options after TNF inhibitor failure.[10][11]

These pediatric studies focus on whether treatment can be safely tapered or changed while keeping disease under control, using outcomes such as flare rates and minimal disease activity.[10][11]

Who can join these trials

Eligibility is different for each study, but the trial data show several main patient groups.[1][2][3][4][5][6][7][8][9][10][11][13]

  • Adults with rheumatoid arthritis, including early disease, moderate to severe disease, or disease that has not responded well to previous therapy.[3][6][7][8][9][13]

  • Patients with specific immune markers, such as ACPA-positive or seropositive rheumatoid arthritis, where the studies try to see if these markers predict response.[1][6][7]

  • Hospitalized adults with COVID-19, in a study of recovery after respiratory infection.[5]

  • Adults with IgG4-related disease or giant cell arteritis, where the goal is to lower recurrence or increase remission.[2][4]

  • Children with juvenile idiopathic arthritis, especially those in remission or those who have failed TNF inhibitor treatment.[10][11]

What the trials measure

The main outcomes are chosen to show whether the disease is better controlled and whether the treatment is safe.[1][2][3][4][5][6][7][8][9][10][11][13]

  • Remission, meaning the disease is very quiet or inactive.[2][4][6][9]

  • Low disease activity, meaning symptoms and signs are present but not severe.[13]

  • Clinical response scores such as ACR50, CDAI, and DAS28-CRP, which are common ways to measure arthritis improvement.[3][6][7][8][9][13]

  • Radiographic progression, which means joint damage seen on X-ray or similar imaging over time.[7]

  • Safety events, including injection-related reactions, adverse events, and serious adverse events.[1][8]

  • Flare rates and drug withdrawal outcomes, especially in juvenile idiopathic arthritis studies that test whether treatment can be reduced safely.[10][11]

Trial phases and study designs

The trial set includes a mix of study designs, but most are interventional, meaning researchers assign the treatment being studied.[1][2][3][4][5][6][7][8][9][10][11][13]

There is one Phase 1 trial in rheumatoid arthritis, which is centered on safety and early signals of response.[1]

There is one Phase 2 trial in IgG4-related disease, which focuses on recurrence prevention over 48 weeks.[2]

The rest of the listed studies are mainly Phase 3 trials, which compare Abatacept with placebo or other active treatments, or compare treatment strategies in larger patient groups.[3][4][5][6][7][8][9][10][11][13]

One rheumatoid arthritis study is listed as Low Intervention, meaning the trial compares treatment strategies with limited extra intervention from the study itself.[13]

Key points for patients

These trials show that Abatacept is being studied across different stages of disease and different age groups, from children to adults.[1][2][3][4][5][6][7][8][9][10][11][13]

Some studies are trying to find the best time to start, switch, taper, or stop treatment, while others compare Abatacept with placebo or with other medicines.[2][4][5][6][7][9][10][11][13]

Overall, the research is focused on finding better ways to control immune-related disease and to identify which patients are most likely to benefit from treatment.[1][2][3][4][5][6][7][8][9][10][11][13]

Trial ID Phase Condition studied Status Enrollment
2024-511536-27-00Phase 1Rheumatoid arthritisAuthorised23
2024-512863-30-00Phase 2IgG4-related diseaseAuthorised32
2024-511470-79-00Phase 3Rheumatoid arthritisAuthorised232
NCT05822583Phase 3COVID-19Completed1545
NCT04474847Phase 3Giant cell arteritisAuthorised78
NCT01491815Phase 3Early rheumatoid arthritisAuthorised705
2023-506450-20-00Phase 3Early, autoantibody-positive rheumatoid arthritisAuthorised400
2023-506664-14-00Phase 3Moderate to severe rheumatoid arthritisCompleted646
NCT03227419Phase 3Rheumatoid arthritisCompleted224
NCT05428488Phase 3Rheumatoid arthritisAuthorised220
NCT06618937Phase 3Juvenile idiopathic arthritisAuthorised328
NCT06654882Phase 3Juvenile idiopathic arthritisAuthorised90
NCT02714634Low InterventionRheumatoid arthritisAuthorised286

Ongoing Clinical Trials on Abatacept

  • Study Comparing Abatacept and Tocilizumab for Adults with Rheumatoid Arthritis Not Responding to Previous Treatments

    Not recruiting

    3 1 1 1
    Investigated drugs:
    France
  • Study Comparing Abatacept and Adalimumab for Adults with Early Rheumatoid Arthritis Not Responding to Methotrexate

    Not recruiting

    3 1 1 1
    Investigated diseases:
    Investigated drugs:
    Czechia France Germany Italy Poland Spain
  • Study on the Effectiveness and Safety of Abatacept Biosimilar (DRL_AB) and Methotrexate for Patients with Moderate to Severe Rheumatoid Arthritis

    Not recruiting

    3 1 1 1
    Investigated diseases:
    Investigated drugs:
    Bulgaria Czechia Estonia Hungary Latvia Lithuania +2
  • Study on Abatacept for Improving Recovery in Hospitalized COVID-19 Patients

    Not recruiting

    3 1 1
    Investigated diseases:
    Investigated drugs:
    Cyprus Denmark France Germany Greece Ireland +3

Glossary

  • Rheumatoid arthritis (RA): A long-term disease where the immune system attacks the joints, causing pain, swelling, and stiffness.
  • IgG4-related disease: A condition where the immune system causes inflammation in different organs and tissues.
  • Giant cell arteritis: Inflammation of blood vessels, usually in older adults, that can cause headaches and other symptoms.
  • Juvenile idiopathic arthritis: Arthritis that begins in childhood and is not caused by another known disease.
  • Clinical trial: A research study in people that tests whether a treatment is safe and works as planned.
  • Phase 1: An early trial phase that mainly checks safety and how people tolerate the treatment.
  • Phase 2: A trial phase that looks more closely at whether the treatment may work and continues safety checks.
  • Phase 3: A larger trial phase that compares treatments and measures how well they work in more people.
  • Remission: A state where signs and symptoms of disease are very low or absent.
  • Biomarker: A measurable sign in the body, such as a lab result or tissue finding, that can help describe disease or predict response.
  • Disease activity: How active the disease is, based on symptoms, exam findings, and test scores.
  • Flare: A period when disease symptoms get worse after being better or stable.

References

  1. https://clinicaltrials.gov/study/2024-511536-27-00
  2. https://clinicaltrials.gov/study/2024-512863-30-00
  3. https://clinicaltrials.gov/study/2024-511470-79-00
  4. https://clinicaltrials.eu/trial/study-on-abatacept-for-improving-recovery-in-hospitalized-covid-19-patients/
  5. https://clinicaltrials.eu/trial/study-on-the-effectiveness-of-abatacept-for-patients-with-giant-cell-arteritis/
  6. https://clinicaltrials.eu/trial/study-comparing-conventional-therapy-and-biologic-treatments-for-early-rheumatoid-arthritis-using-hydroxychloroquine-abatacept-and-azathioprine-in-responsive-patients/
  7. https://clinicaltrials.gov/study/2023-506450-20-00
  8. https://clinicaltrials.gov/study/2023-506664-14-00
  9. https://clinicaltrials.eu/trial/study-comparing-abatacept-and-tocilizumab-for-adults-with-rheumatoid-arthritis-not-responding-to-previous-treatments/
  10. https://clinicaltrials.eu/trial/study-on-early-drug-withdrawal-in-children-with-juvenile-idiopathic-arthritis-using-secukinumab-and-drug-combination-for-those-in-clinical-remission/
  11. https://clinicaltrials.eu/trial/study-of-abatacept-tocilizumab-and-tofacitinib-compared-to-a-second-tnf-inhibitor-for-children-with-juvenile-idiopathic-arthritis-who-did-not-respond-to-tnf-inhibitor-treatment/
  12. https://clinicaltrials.eu/trial/study-comparing-methotrexate-or-leflunomide-with-targeted-therapy-vs-methotrexate-or-leflunomide-with-drug-combination-for-rheumatoid-arthritis-patients/
  13. https://clinicaltrials.eu/trial/study-on-abatacept-for-rheumatoid-arthritis-in-patients-responding-to-initial-tnf-inhibitor-treatment/