a Rheumatology Service , Hospital Clinico Universitario , Santiago de Compostela , Spain.
b Fundacion Ramon Dominguez, Hospital Clinico Universitario , Santiago de Compostela , Spain.
Expert Rev Clin Immunol. 2019 Apr;15(4):319-326. doi: 10.1080/1744666X.2019.1579642. Epub 2019 Feb 18.
Rheumatoid arthritis (RA) is a complex disease in which different mechanisms are involved. Studies suggest a key role for aberrant pathways of T-cell activation in the initiation and perpetuation of disease. Abatacept is a fusion protein composed of the Fc region of the immunoglobulin G1 (IgG1) fused to the extracellular domain of cytotoxic T lymphocyte-associated antigen (CTLA4). It has the ability to modulate T-cell activation by interfering with co-stimulation of these cells, a necessary step to become activated. This suggests that abatacept may play a role in the progression and/or even the initiation of RA. Areas covered: a review of the different studies carried out during clinical development of abatacept was performed. Both formulations, intravenous (IV) and subcutaneous (SC), showed a similar and consistent efficacy and safety profile. Abatacept was effective both in RA patients not responding to methotrexate (MTX) and to tumor necrosis factor (TNF) inhibitors. Expert commentary: abatacept, with its unique mechanism of action, proved to be a useful therapeutic alternative in RA, also having an acceptable safety profile. Evidence points out that abatacept may be able to alter the RA disease course. Ongoing studies will clarify this issue.
类风湿关节炎（RA）是一种复杂的疾病，其中涉及不同的机制。研究表明，T 细胞激活的异常途径在疾病的起始和持续中起着关键作用。阿巴西普是一种融合蛋白，由免疫球蛋白 G1（IgG1）的 Fc 区域与细胞毒性 T 淋巴细胞相关抗原（CTLA4）的细胞外结构域融合而成。它具有通过干扰这些细胞的共刺激来调节 T 细胞激活的能力，这是激活的必要步骤。这表明阿巴西普可能在 RA 的进展甚至起始中发挥作用。涵盖领域：对阿巴西普临床开发过程中进行的不同研究进行了回顾。静脉内（IV）和皮下（SC）两种制剂均显示出相似且一致的疗效和安全性。阿巴西普在对甲氨蝶呤（MTX）和肿瘤坏死因子（TNF）抑制剂无反应的 RA 患者中均有效。专家评论：阿巴西普具有独特的作用机制，已被证明是 RA 的一种有用的治疗选择，且具有可接受的安全性。有证据表明，阿巴西普可能能够改变 RA 的疾病进程。正在进行的研究将阐明这个问题。
