Should abatacept and rituximab always be used with MTX?
In phase II studies, both abatacept and rituximab were assessed as monotherapy, without concomitant methotrexate. However, the bulk of the development program for both agents has assessed patients on concomitant MTX. For rituximab, in the phase II study where MTX was withdrawn and rituximab monotherapy used in 1 group 4, it appeared that clinical responses to rituximab were not as long-lasting as in the group on combination rituximab plus MTX. With other biologic agents, combination therapy with MTX has afforded synergistic clinical efficacy and in some cases beneficial pharmacokinetic interactions. The extent to which this may be seen with newer biologic agents remains to be fully defined. For the present time, in most cases clinicians will probably use these agents in conjunction with MTX. What about cost and administration? Abatacept: Abatacept is administered i.v. over approximately 30 minutes with the fixed dose approximating 10mg/kg using 2, 3, or 4 250mg vials. The current Avera
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- Should abatacept and rituximab always be used with MTX?
