Abatacept treatment reduces disease activity in early primary Sjögren's syndrome (open-label proof of concept ASAP study)

Meiners, Petra M.; Vissink, Arjan; Kroese, Frans G. M.; Spijkervet, Frederik; Smitt-Kamminga, Nicole Sillevis; Abdulahad, Wayel H.; Bulthuis-Kuiper, Janita; Brouwer, Elisabeth; Arends, Suzanne; Bootsma, Hendrika

doi:10.1136/annrheumdis-2013-204653

Cited by 213 publications

(122 citation statements)

References 18 publications

(9 reference statements)

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“…The improvement verified in the ESSPRI of patients in the present study after periodontal therapy was similar to that found by studies evaluating the effects of using rituximab and abatacept for 4 weeks on disease symptoms. 37,38 In the present study, we also found a low correlation between the ESSPRI and the ESSDAI indexes (r = 0.31); this reinforces the need to associate the assessments of these important indexes in relation to pSS, as pointed out by Seror et al 39 Moreover, there were no significant changes in the medications and the dosage along the experimental periods of the present study. Therefore, it can be suggested that the periodontal treatment itself may be the only factor responsible for the improved salivary flow and quality of life of patients with pSS.…”

Section: Discussionsupporting

confidence: 54%

Effects of periodontal treatment on primary sjȫgren’s syndrome symptoms

et al. 2017

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Section: Discussionsupporting

confidence: 54%

Effects of periodontal treatment on primary sjȫgren’s syndrome symptoms

et al. 2017

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“…In an open-label pilot study of abatacept in active pSS, patients with recent onset of pSS and high disease activity were monitored. During the intravenous abatacept treatment, ESSDAI, ESSPRI, rheumatoid factor, and IgG levels decreased significantly, and fatigue and health-related quality of life improved significantly [16]. Abatacept also induces clinical improvement in patients with severe and treatment-resistant diffuse SSc [15].…”

Section: Cd80/cd86 Cd28 and Ctla-4mentioning

confidence: 87%

“…Being chronic systemic autoimmune diseases, permanent activation of the adaptive immune system is obvious in both pSS and SSc [12,13]. The recognition of the outstanding importance of the costimulatory regulation in many autoimmune diseases and in tumor-immunology has lead to highly effective targeted therapies in both fields [14][15][16].…”

Section: Introductionmentioning

confidence: 99%

The role of B7 family costimulatory molecules and indoleamine 2,3-dioxygenase in primary Sjögren’s syndrome and systemic sclerosis

et al. 2016

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B7 costimulatory molecules are present on antigenpresenting cells (APCs) and influence intracellular expression of indoleamine 2,3-dioxygenase (IDO), a molecule with important immunoregulatory functions. We determined the frequency of activated (CD11b+) monocytes expressing B7-1, B7-2, B7-H1, and B7-H2 molecules, and that of CD3+ and CD4+ T cells expressing the corresponding CD28, CTLA-4, PD-1, and ICOS receptors in peripheral blood samples of 20 healthy adults and 9 SSc and 15 pSS patients using flow cytometry. We also examined the intracellular expression of IDO. The expression of CD28 was lower in both SSc and pSS patients. The frequency of CTLA-4 was increased in pSS. The expression of ICOS, a stimulator of T cell activation, was elevated in pSS, but not in SSc, while that of its corresponding costimulatory molecule, B7-H2, was strongly decreased in SSc compared to controls. The frequency of PD-1 expressing T lymphocytes was decreased in both pSS and SSc. The frequency of IDO-expressing APCs, as well as intracellular IDO content in T cells was higher in pSS than in controls. Our investigation identified a number of differences in B7 costimulation between SSc and pSS patients which may play a role in the distinct pathogenesis and clinical features of these autoimmune disorders.

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“…[115] Two small open-label trials of IV abatacept treatment in pSS have shown that abatacept decreases ESSDAI, ESSPRI, IgG, and rheumatoid factor, improves fatigue and decreases glandular inflammation. In the study by Meiners et al, [116] mild-tomoderate infusion reactions occurred in 40% of the patients in <1 hour of infusion (mostly hypotension and dizziness), and infections occurred in 66% of patients (mostly mild upper respiratory tract infections). Adler et al did not include a safety analysis plan in their methods, but did report that 27% of the patients experienced an AE, of which one was infectious (diverticulitis).…”

Section: Abataceptmentioning

confidence: 99%

Safety of treatments for primary Sjögren’s syndrome

Nimwegen

Moerman

Smitt

et al. 2016

Expert Opinion on Drug Safety

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Introduction: Primary Sjögren's syndrome (pSS) is a disabling auto-immune disease, affecting exocrine glands and several organs. Areas covered:In this review we analyze the safety of therapies used in pSS. Symptomatic treatment is widely applied due to the good supportive effect and good safety profile. Systemic stimulation of tears and saliva can be successful in pSS. However, cumbersome adverse events can influence the tolerability of this therapy. Evidence for the effectiveness of synthetic DMARDs therapies in pSS is limited, while there is a risk of adverse events. Several studies on biologic DMARD treatment of pSS patients have shown promising efficacy and safety results. Expert opinion: The safety of symptomatic treatment of pSS is very good. However, systemic therapy is necessary to achieve long-term relieve and prevention of organ-damage. Synthetic DMARDs have not shown much efficacy in earlier studies, and their benefits do not weigh up to the possible harms, while biologic DMARDs show promising results regarding efficacy and cause mostly mild adverse events. Many questions remain unanswered regarding safety of DMARDs in pSS. There is a need for well designed studies, in which safety should be evaluated in a uniform manner to be able to compare the results between studies.ARTICLE HISTORY

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Abatacept treatment reduces disease activity in early primary Sjögren's syndrome (open-label proof of concept ASAP study)

Abstract: 2009-015558-40.

Cited by 213 publications

References 18 publications

Effects of periodontal treatment on primary sjȫgren’s syndrome symptoms

Effects of periodontal treatment on primary sjȫgren’s syndrome symptoms

The role of B7 family costimulatory molecules and indoleamine 2,3-dioxygenase in primary Sjögren’s syndrome and systemic sclerosis

Safety of treatments for primary Sjögren’s syndrome

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