{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T20:13:48Z","timestamp":1776456828088,"version":"3.51.2"},"reference-count":47,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2023,4,22]],"date-time":"2023-04-22T00:00:00Z","timestamp":1682121600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,4,22]],"date-time":"2023-04-22T00:00:00Z","timestamp":1682121600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Arthritis Res Ther"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>AVERT-2 (a phase IIIb, two-stage study) evaluated abatacept\u2009+\u2009methotrexate versus methotrexate alone, in methotrexate-naive, anti-citrullinated protein antibody-positive patients with early (\u2264\u20096\u00a0months), active RA. This subanalysis investigated whether individual patients who achieved the week 24 Simplified Disease Activity Index (SDAI) remission primary endpoint could sustain remission to 1\u00a0year and then maintain it following changes in therapy.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>During the 56-week induction period (IP), patients were randomized to weekly subcutaneous abatacept 125\u00a0mg\u2009+\u2009methotrexate or abatacept placebo\u2009+\u2009methotrexate. Patients completing the IP who achieved SDAI remission (\u2264\u20093.3) at weeks 40 and 52 entered a 48-week de-escalation (DE) period. Patients treated with abatacept\u2009+\u2009methotrexate were re-randomized to continue weekly abatacept\u2009+\u2009methotrexate, or de-escalate and then withdraw abatacept (after 24\u00a0weeks), or receive abatacept monotherapy. Proportions of patients achieving sustained SDAI and Boolean remission, and Disease Activity\u00a0Score in 28 joints using C-reactive protein (DAS28 [CRP])\u2009&lt;\u20092.6, were assessed. For patients achieving early sustained SDAI remission at weeks 24\/40\/52, flow between disease activity categories and individual trajectories was evaluated; flow was also evaluated for later remitters (weeks 40\/52 but not week 24).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Among patients treated with abatacept\u2009+\u2009methotrexate (<jats:italic>n<\/jats:italic>\/<jats:italic>N<\/jats:italic>\u2009=\u2009451\/752) at IP week 24, 22% achieved SDAI remission, 17% achieved Boolean remission, and 42% achieved DAS28 (CRP)\u2009&lt;\u20092.6; of these, 56%, 58%, and 74%, respectively, sustained a response throughout IP weeks 40\/52. Among patients with a sustained response at IP weeks 24\/40\/52, 82% (14\/17) on weekly abatacept\u2009+\u2009methotrexate, 81% (13\/16) on abatacept monotherapy, 63% (12\/19) who de-escalated\/withdrew abatacept, and 65% (11\/17) on abatacept placebo\u2009+\u2009methotrexate were in SDAI remission at end of the DE period; rates were higher than for later remitters in all arms except abatacept placebo\u2009+\u2009methotrexate.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>A high proportion of individual patients achieving clinical endpoints at IP week 24 with abatacept\u2009+\u2009methotrexate sustained their responses through week 52. Of patients achieving early and sustained SDAI remission through 52\u00a0weeks, numerically more maintained remission during the DE period if weekly abatacept treatment continued.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Trial registration<\/jats:title>\n                <jats:p>NCT02504268 (ClinicalTrials.gov), registered July 21, 2015.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13075-023-03038-2","type":"journal-article","created":{"date-parts":[[2023,4,22]],"date-time":"2023-04-22T09:02:19Z","timestamp":1682154139000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["The trajectory of clinical responses in patients with early rheumatoid arthritis who achieve sustained remission in response to abatacept: subanalysis of AVERT-2, a randomized phase IIIb study"],"prefix":"10.1186","volume":"25","author":[{"given":"Paul","family":"Emery","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshiya","family":"Tanaka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vivian P.","family":"Bykerk","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clifton O.","family":"Bingham","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas W. 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The protocol and patients\u2019 informed consent received institutional review board\/independent ethics committee approval prior to initiation of the study, and all patients provided informed consent prior to enrollment. The AVERT-2 study was governed by both a central institutional review board (IRB; the New England IRB) as well as local and university-based IRBs if required at individual sites. Approval numbers per site were not provided and are not available.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"PE has received grant\/research support from Bristol Myers Squibb, Lilly, Novartis and Samsung; has received consulting fees from Boehringer Ingelheim, Bristol Myers Squibb, Lilly and Novartis; has received honoraria from Bristol Myers Squibb, Celltrion, GlaxoSmithKline, Lilly, Novartis and Samsung; and received support for meetings\/travel from Novartis. YT has received grant\/research support from AbbVie, Asahi-Kasei, Boehringer Ingelheim, Chugai, Corrona, Daiichi-Sankyo, Eisai and Takeda; and has received honoraria from AbbVie, AstraZeneca, Boehringer Ingelheim, Bristol Myers Squibb, Chugai, Daiichi-Sankyo, Eisai, Eli Lilly, Gilead, GlaxoSmithKline, Mitsubishi-Tanabe and Pfizer. VPB has received grant\/research support from NIH\/fNIH (Accelerated Medicines Program; funds to institution; grants 1UH2AR067691-01 and GRANT11652401) and Cedar Hill; has received consulting fees from Amgen, Bristol Myers Squibb, Genzyme, Gilead, Janssen, Sanofi and UCB; has participated on a Data Safety Monitoring Board for KAI; and acted as Project Advisor for Pfizer. Additionally, VPB\u2019s spouse is an employee of and has ownership interest in Brainstorm Therapeutics. COB has received grant\/research support from Bristol Myers Squibb; has received royalties from UpToDate; has received consulting fees from AbbVie, Bristol Myers Squibb, Janssen, Pfizer, Regeneron and Sanofi; has participated on a Data Safety Monitoring Board for Moderna; and is on the Executive Committee for OMERACT (unpaid). TWJH\/the Department of Rheumatology LUMC has received research support\/lecture fees\/consultancy fees from Bristol Myers Squibb, Eli Lilly, Galapagos, Janssen and Pfizer. GC has received consulting fees, speaker fees and\/or honoraria from AbbVie, Bristol Myers Squibb, Eli Lilly, Gema Biotech, Janssen and Pfizer. K-HGH and RW were employees of (at the time of analysis) and are shareholders in Bristol Myers Squibb; K-HGH is currently an employee of and shareholder in Johnson & Johnson. CW, SEC, and KL are employees of and shareholders in Bristol Myers Squibb. YE has received consulting fees from Bristol Myers Squibb. RF has received consulting fees from AbbVie, Amgen, Bristol Myers Squibb, Cambrian, GlaxoSmithKline, Novartis, Pfizer, Teijin and Vyne; has received honoraria from AbbVie and Pfizer; and has participated on Data Safety Monitoring Boards for AbbVie, GlaxoSmithKline and Pfizer.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"67"}}