Rheumatoid Arthritis
Conditions
Brief summary
The purpose of this clinical research study is to learn if abatacept is safe when co-administered with other approved rheumatoid arthritis medications.
Detailed description
This was a multinational, multicenter, randomized, double-blind, 2-arm, parallel-dosing designed study. The treatment period was 12 months. Eligible participants were randomized to 1 of 2 treatment groups: abatacept fixed dose approximating 10 mg/kg (based on participant's body weight; 500 mg for participants weighing \< 60kg; 750 mg for participants weighing 60 to 100 kg; and 1 gram for participants weighing \> 100 kg, monthly) or placebo intravenous (IV) infusion. All participants continued their background therapy(ies) for rheumatoid arthritis (RA) (non-biologic or biologic disease-modifying drugs \[DMARDs\], or combination) throughout the double-blind treatment period. Double-blind study medication (abatacept or placebo) was administered on Days 1, 15, 29, and every 28 days thereafter, for a total of 14 doses. All participants who completed the 12-month double-blind study period (Day 1 through Day 365), were eligible to continue into the open-label period. All eligible participants (active or placebo) were re-allocated to receive abatacept at a weight-tiered dose that approximated 10 mg/kg, based on their Day 365 body weight. Participants continued to receive infusions every 28 days.
Interventions
Concentrate and diluted in a solution, IV, 500 mg (body weight \< 60 Kg); 750 mg (body weight 60-100 Kg); 1000 mg (body weight \> 100 Kg), Once daily, Day 1, 15, and 29.
Concentrate and diluted in a solution, IV, 0 mg, Once daily, Day 1, 15, and 29.
Concentrate and diluted in a solution, IV, 500 mg (body weight \< 60 Kg); 750 mg (body weight 60-100 Kg); 1000 mg (body weight \> 100 Kg), Once daily, Every 28 days.
Sponsors
Study design
Eligibility
Inclusion criteria
* Meet criteria of American Rheumatism Association for the diagnosis of rheumatoid arthritis and the American College of Rheumatology functional classes I, II III or IV * Participants must be taking 1 or more DMARDs and/or biologic approved for rheumatoid arthritis (RA) for at least 3 months and be on a stable dose for 28 days prior to Day 1. Exclusion: * Other auto-immune disease as a main diagnosis (e.g. Systemic Lupus Erythematosus \[SLE\], Scleroderma) * Active tuberculosis (TB) requiring treatment within last 3 years
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| OL; Number of Participants With Clinically Significant Physical Examination or Vital Signs Abnormalities | Days 365 to Day 1821 | Physical examinations were performed at the discretion of the investigator and included breast examinations for female participants. Vital sign measurements were performed for participants before and after infusion of study medication at each visit and included seated systolic blood pressure, seated diastolic blood pressure, temperature, and heart rate. Abnormalities were determined to be clinically significant by the investigator. |
| OL; Number of Participants With Electrolyte Laboratories Meeting Marked Abnormality Criteria | Day 365 to Day 1821, and including data up to 56 days post last dose of double-blind medication | Marked abnormality criteria: Sodium (Na): \<0.95\*LLN/ \>1.05\*ULN, or if BL\<LLN then use \<0.95\* BL or \>ULN, or if BL\>ULN then use\>1.05\* BL or \<LLN; potassium (K): \<0.9\* LLN/\>1.1\*ULN, or if BL\<LLN then use \<0.9\* BL or \>ULN, or if BL\>ULN then use\>1.1\* BL or \<LLN; (Cl): \<0.9\* LLN/\>1.1\* ULN, or if BL\<LLN then use \<0.9\* BL or \>ULN, or if BL\>ULN then use\>1.1\* BL or \<LLN; calcium (Ca): \<0.8\* LLN/\>1.2\* ULN, or if BL\<LLN then use \<0.75\* BL or \>ULN, or if BL\>ULN then use\>1.25\* BL or \<LLN; phosphorous (P): \<0.75\* LLN/ \>1.25\* ULN, or if BL\<LLN then use 0.67\* BL or \>ULN, or if BL\>ULN then use\>1.33\* BL or \<LLN |
| OL; Number of Participants With Other Chemistry and Urinalysis Laboratories Meeting Marked Abnormality Criteria | Day 365 to Day 1821, and including data up to 56 days post last dose of double-blind medication | MA criteria: serum glucose (Glu): \<65 mg/dL/\>220 mg/dL;fasting serum Glu: \<0.8\* LLN/\>1.5\*ULN,or if BL\<LLN then use 0.8\*BL or \>ULN,or if BL\>ULN then use \>2.0\*BL or \<LLN;total protein: \<0.9\*LLN/\>1.1\*ULN,or if BL\<LLN then use \<0.9\*BL or \>UNL,or if BL\>UNL then use \>1.1\*BL or \<LLN; albumin: \<0.9\*LLN,or if BL\<LLN then use \<0.75 BL;uric acid: \>1.5\*ULN,or if BL\>ULN then use \>2\*BL. Urinalysis (Urine protein,urine Glu,urine blood,leukocyte esterase,Red Blood Cells \[RBCs\], White Blood Cells \[WBCs\]):Use ≥2 when BL value missing or when pre-dose=0 or 0.5; use ≥3 when pre-dose=1, use ≥4 when pre-dose=2 or 3 |
| Double Blind Period (DB); Number of Participants With Death, Serious Adverse Events (SAEs), Related SAEs, SAEs Leading to Discontinuation, Adverse Events (AEs), Related AEs, or AEs Leading to Discontinuation | Day 1 to Day 365, and including data up to 56 days post last dose of double-blind medication | AE=any new untoward medical occurrence or worsening of a pre-existing medical condition which does not necessarily have a causal relationship with this treatment. SAE=any untoward medical occurrence that at any dose: results in death, is life-threatening, requires inpatient hospitalization or causes prolongation of existing hospitalization, results in persistent or significant disability/incapacity, is a congenital anomaly/birth defect, results in development of drug dependency or drug abuse, is an important medical event. Related SAE/AE = possibly, probably, or certainly related to study drug |
| DB; Number of Participants With AEs of Special Interest | Day 1 to Day 365, and including data up to 56 days post last dose of double-blind medication | AE=any new untoward medical occurrence or worsening of a pre-existing medical condition which does not necessarily have a causal relationship with this treatment. AEs of special interest are those AEs that may be associated with the use of immunomodulatory drugs, including all infections, serious infections, and opportunistic infections; autoimmune disorders; neoplasms; acute infusional AEs (pre-specified AEs occurring within 1 hour of start of infusion) and peri-infusional AEs (pre-specified AEs occurring within 24 hours of the start of infusion). |
| DB; Number of Participants With Hematology Laboratories Meeting Marked Abnormality Criteria | Day 1 to Day 365, and including data up to 56 days post last dose of double-blind medication | Upper Normal Limit (ULN), Lower Normal Limit (LLN), Baseline (BL). Marked abnormality criteria are: Hemoglobin (HGB): \>3 g/dL decrease from BL; Hematocrit: \<0.75 \* BL; Erythrocytes: \<0.75 \* BL; Platelets (PLT): \<0.67 \* LLN/\>1.5 \* ULN, or if BL \< LLN then use \<0.5 \* BL and \<100,000 mm\^3; Leukocytes: \<0.75 \* LLN/ \>1.25 \* ULN, or if BL\<LLN then use \<0.8 \* BL or \>ULN, or if BL\>ULN then use \>1.2 \* BL or \<LLN; neutrophils+bands: \<1.0 \* 10\^3 c/uL; eosinophils: \>0.750 \* 10\^3 c/uL; basophils: \> 400 mm\^3; monocytes: \>2000 mm\^3; lymphocytes: \<0.750 \* 10\^3 c/uL/ \>7.50 \* 10\^3 c/uL. |
| DB; Number of Participants With Blood Chemistry Laboratories Meeting Marked Abnormality (MA) Criteria | Day 1 to Day 365, and including data up to 56 days post last dose of double-blind medication | ULN=upper level of normal; BL=baseline.Marked abnormality criteria: High alkaline phosphatase (ALP): \>2\* ULN, or if BL\>ULN then use \>3\* BL; high aspartate aminotransferase (AST): \>3\* ULN (80 U/L), or if BL\>ULN then use \>4\* BL; high alanine aminotransferase (ALT): \>3\* ULN (34-47 U/L), or if BL\>ULN then use \>4\* BL; high G-Glutamyl transferase (GGT): \>2\* ULN, or if BL\>ULN then use \>3\* BL; high bilirubin: \>2\* ULN, or if BL\>ULN then use \>4\* BL; high blood urea nitrogen (BUN): \>2\* BL; high creatinine: \>1.5\* BL (ULN 14.6 pg/mg. AST ULN=80 U/L; ALT ULN=34-47 U/L;creatinine ULN=14.6 pg/mg. |
| DB; Number of Participants With Clinically Significant Physical Examination or Vital Signs Abnormalities | Days 1, 15, 29, 57, 85, 113, 141, 169, 197, 225, 253, 281, 309, 337. Vital signs were measured at these visits before and after study medication infusion. | Physical examinations were performed at the discretion of the investigator and included breast examinations for female participants. Vital sign measurements were performed for participants before and after infusion of study medication at each visit and included seated systolic blood pressure, seated diastolic blood pressure, temperature, and heart rate. Abnormalities were determined to be clinically significant by the investigator. |
| Open Label Period (OL); Number of Participants With Death, Serious Adverse Events (SAEs), Related SAEs, SAEs Leading to Discontinuation, Adverse Events (AEs), Related AEs, or AEs Leading to Discontinuation | Day 365 to Day 1,821 | AE=any new untoward medical occurrence or worsening of a pre-existing medical condition which does not necessarily have a causal relationship with this treatment. SAE=any untoward medical occurrence that at any dose: results in death, is life-threatening, requires inpatient hospitalization or causes prolongation of existing hospitalization, results in persistent or significant disability/incapacity, is a congenital anomaly/birth defect, results in development of drug dependency or drug abuse, is an important medical event. Related SAE/AE = possibly, probably, or certainly related to study drug |
| OL; Number of Participants With AEs of Special Interest | Day 365 to Day 1821 | AE=any new untoward medical occurrence or worsening of a pre-existing medical condition which does not necessarily have a causal relationship with this treatment. AEs of special interest are those AEs that may be associated with the use of immunomodulatory drugs, including all infections, serious infections, and opportunistic infections; autoimmune disorders; neoplasms; acute infusional AEs (pre-specified AEs occurring within 1 hour of start of infusion) and peri-infusional AEs (pre-specified AEs occurring within 24 hours of the start of infusion). |
| OL; Number of Participants With Hematology Laboratories Meeting Marked Abnormality Criteria | Day 365 to Day 1821, and including data up to 56 days post last dose of double-blind medication | Upper Normal Limit (ULN), Lower Normal Limit (LLN), Baseline (BL). Marked abnormality criteria are: Hemoglobin (HGB): \>3 g/dL decrease from BL; Hematocrit: \<0.75 \* BL; Erythrocytes: \<0.75 \* BL; Platelets (PLT): \<0.67 \* LLN/\>1.5 \* ULN, or if BL \< LLN then use \<0.5 \* BL and \<100,000 mm\^3; Leukocytes: \<0.75 \* LLN/ \>1.25 \* ULN, or if BL\<LLN then use \<0.8 \* BL or \>ULN, or if BL\>ULN then use \>1.2 \* BL or \<LLN; neutrophils+bands: \<1.0 \* 10\^3 c/uL; eosinophils: \>0.750 \* 10\^3 c/uL; basophils: \> 400 mm\^3; monocytes: \>2000 mm\^3; lymphocytes: \<0.750 \* 10\^3 c/uL/ \>7.50 \* 10\^3 c/uL. |
| OL; Number of Participants With Liver Function Laboratories Meeting Marked Abnormality Criteria | Day 365 to Day 1821, and including data up to 56 days post last dose of double-blind medication | Marked abnormality criteria: Alkaline phosphatase (ALP): \>2\* ULN, or if BL\>ULN then use \>3\* BL; aspartate aminotransferase (AST): \>3\* ULN, or if BL\>ULN then use \>4\* BL; alanine aminotransferase (ALT): \>3\* ULN, or if BL\>ULN then use \>4\* BL; G-Glutamyl transferase (GGT): \>2\* ULN, or if BL\>ULN then use \>3\* BL; Bilirubin: \>2\* ULN, or if BL\>ULN then use \>4\* BL; blood urea nitrogen (BUN): \>2\* BL; creatinine: \>1.5\* BL |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| DB; Number of Participants With Positive Anti-Abatacept or Anti-Cytotoxic T-Lymphocyte Antigen 4 (CTLA4) Responses by ELISA | Days 1, 15, 29, 57, 85, 113, 141, 169, 197, 225, 253, 281, 309, 337 | Serum samples from all treated adult participants with active rheumatoid arthritis were screened for the presence of drug-specific antibodies using ELISA. Immunogenicity was defined as the presence of a positive anti-abatacept or anti-CTLA4 antibody. |
| DB; Number of Participants With Positive Anti-Abatacept or Anti-Cytotoxic T-Lymphocyte Antigen 4 (CTLA4) Responses by Enzyme-Linked Immunosorbant Assay (ELISA) | Days 1, 29, 57, 85, 113,169, 281, 365 | Serum samples from all treated adult participants with active rheumatoid arthritis (RA) were screened for the presence of drug-specific antibodies using ELISA. Immunogenicity was defined as the presence of a positive anti-abatacept or anti-CTLA4 antibody. |
Countries
United States
Participant flow
Pre-assignment details
1795 enrolled in study and 339 were not randomized due to no longer meeting study criteria (n=214), withdraw of consent (n=83), other reasons (n=32), participant was lost to follow-up (n=5), administrative reason by sponsor (n=2), adverse event (n=2), and poor/non-compliance (n=1). Of 1456 randomized, 15 were not treated.
Participants by arm
| Arm | Count |
|---|---|
| Abatacept (ABA) Participants received a fixed dose of abatacept approximating 10 mg/kg (500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 g for participants \> 100 kg). Abatacept was administered intravenously (IV) on Days 1, 15, 29, and every 28 days thereafter, for a total of 14 doses. Participants also received background therapy(ies) for rheumatoid arthritis (RA) (non-biologic or biologic disease-modifying drugs \[DMARDs\], or combination) throughout the double-blind treatment period. | 959 |
| Placebo (PLA) Participants received Placebo (dextrose 5% water \[D5W\] for injection U.S.P or normal saline \[NS\]) for IV infusion administered on Days 1, 15, 29, and every 28 days thereafter, for a total of 14 doses. Participants also received background therapy(ies) for rheumatoid arthritis (RA) (non-biologic or biologic disease-modifying drugs \[DMARDs\], or combination) throughout the double-blind treatment period. | 482 |
| Total | 1,441 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 | FG002 |
|---|---|---|---|---|
| Double Blind Period (DB) | Administrative Reason By Sponsor | 1 | 0 | 0 |
| Double Blind Period (DB) | Adverse Event | 51 | 19 | 0 |
| Double Blind Period (DB) | Death | 5 | 3 | 0 |
| Double Blind Period (DB) | Lack of Efficacy | 26 | 44 | 0 |
| Double Blind Period (DB) | Lost to Follow-up | 3 | 4 | 0 |
| Double Blind Period (DB) | Missed 2 doses while undergoing work-up | 1 | 0 | 0 |
| Double Blind Period (DB) | No Longer Meets Study Criteria | 8 | 2 | 0 |
| Double Blind Period (DB) | Poor/Non-Compliance | 2 | 4 | 0 |
| Double Blind Period (DB) | Pregnancy | 1 | 0 | 0 |
| Double Blind Period (DB) | Relocation | 1 | 0 | 0 |
| Double Blind Period (DB) | Uncontrolled hypertension | 0 | 1 | 0 |
| Double Blind Period (DB) | Withdrawal by Subject | 24 | 10 | 0 |
| Open Label Period (OL) | Administrative Reason By Sponsor | 0 | 0 | 20 |
| Open Label Period (OL) | Adverse Event | 0 | 0 | 103 |
| Open Label Period (OL) | Death | 0 | 0 | 25 |
| Open Label Period (OL) | Difficult IV Access with Participant | 0 | 0 | 1 |
| Open Label Period (OL) | Investigator Decision | 0 | 0 | 4 |
| Open Label Period (OL) | Investigator Dosing the Trial | 0 | 0 | 1 |
| Open Label Period (OL) | Investigator Retiring | 0 | 0 | 2 |
| Open Label Period (OL) | Lack of Efficacy | 0 | 0 | 81 |
| Open Label Period (OL) | Lost to Follow-up | 0 | 0 | 27 |
| Open Label Period (OL) | Medication Lost Efficacy | 0 | 0 | 1 |
| Open Label Period (OL) | No Longer Meets Study Criteria | 0 | 0 | 5 |
| Open Label Period (OL) | Participant Desires Pregnancy | 0 | 0 | 2 |
| Open Label Period (OL) | Participant Missed Consecutive Doses | 0 | 0 | 5 |
| Open Label Period (OL) | Participant Received Wrong Medication | 0 | 0 | 1 |
| Open Label Period (OL) | Participant Relocated | 0 | 0 | 6 |
| Open Label Period (OL) | Participant Surgery | 0 | 0 | 1 |
| Open Label Period (OL) | Participant Transportation Issues | 0 | 0 | 1 |
| Open Label Period (OL) | Patient Decision | 0 | 0 | 4 |
| Open Label Period (OL) | Poor/Non-Compliance | 0 | 0 | 13 |
| Open Label Period (OL) | Pregnancy | 0 | 0 | 6 |
| Open Label Period (OL) | Site Closure | 0 | 0 | 3 |
| Open Label Period (OL) | Site Not Participating in Open Label | 0 | 0 | 9 |
| Open Label Period (OL) | Site Staff Issues | 0 | 0 | 2 |
| Open Label Period (OL) | Trial Terminated | 0 | 0 | 1 |
| Open Label Period (OL) | Withdrawal by Subject | 0 | 0 | 117 |
Baseline characteristics
| Characteristic | Abatacept (ABA) | Placebo (PLA) | Total |
|---|---|---|---|
| Age Continuous | 52.4 years STANDARD_DEVIATION 11.7 | 52.1 years STANDARD_DEVIATION 12 | 52.3 years STANDARD_DEVIATION 11.8 |
| Sex: Female, Male Female | 789 Participants | 398 Participants | 1187 Participants |
| Sex: Female, Male Male | 170 Participants | 84 Participants | 254 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk |
|---|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — | — / — |
| other Total, other adverse events | 1,010 / 1,184 | 715 / 959 | 346 / 482 |
| serious Total, serious adverse events | 425 / 1,184 | 124 / 959 | 59 / 482 |
Outcome results
DB; Number of Participants With AEs of Special Interest
AE=any new untoward medical occurrence or worsening of a pre-existing medical condition which does not necessarily have a causal relationship with this treatment. AEs of special interest are those AEs that may be associated with the use of immunomodulatory drugs, including all infections, serious infections, and opportunistic infections; autoimmune disorders; neoplasms; acute infusional AEs (pre-specified AEs occurring within 1 hour of start of infusion) and peri-infusional AEs (pre-specified AEs occurring within 24 hours of the start of infusion).
Time frame: Day 1 to Day 365, and including data up to 56 days post last dose of double-blind medication
Population: All Treated Participants, all participants who received at least 1 dose of study medication
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Abatacept (ABA) | DB; Number of Participants With AEs of Special Interest | Infections/Infestations | 95 participants |
| Abatacept (ABA) | DB; Number of Participants With AEs of Special Interest | Serious Infections/Infestations | 17 participants |
| Abatacept (ABA) | DB; Number of Participants With AEs of Special Interest | Neoplasms | 34 participants |
| Abatacept (ABA) | DB; Number of Participants With AEs of Special Interest | Pre-specified Autoimmune Disorders | 32 participants |
| Abatacept (ABA) | DB; Number of Participants With AEs of Special Interest | Pre-specified Acute Infusional AEs | 96 participants |
| Abatacept (ABA) | DB; Number of Participants With AEs of Special Interest | Pre-specified Peri-Infusional AEs | 233 participants |
| Placebo (PLA) | DB; Number of Participants With AEs of Special Interest | Pre-specified Acute Infusional AEs | 34 participants |
| Placebo (PLA) | DB; Number of Participants With AEs of Special Interest | Infections/Infestations | 40 participants |
| Placebo (PLA) | DB; Number of Participants With AEs of Special Interest | Pre-specified Autoimmune Disorders | 15 participants |
| Placebo (PLA) | DB; Number of Participants With AEs of Special Interest | Serious Infections/Infestations | 5 participants |
| Placebo (PLA) | DB; Number of Participants With AEs of Special Interest | Pre-specified Peri-Infusional AEs | 98 participants |
| Placebo (PLA) | DB; Number of Participants With AEs of Special Interest | Neoplasms | 17 participants |
DB; Number of Participants With Blood Chemistry Laboratories Meeting Marked Abnormality (MA) Criteria
ULN=upper level of normal; BL=baseline.Marked abnormality criteria: High alkaline phosphatase (ALP): \>2\* ULN, or if BL\>ULN then use \>3\* BL; high aspartate aminotransferase (AST): \>3\* ULN (80 U/L), or if BL\>ULN then use \>4\* BL; high alanine aminotransferase (ALT): \>3\* ULN (34-47 U/L), or if BL\>ULN then use \>4\* BL; high G-Glutamyl transferase (GGT): \>2\* ULN, or if BL\>ULN then use \>3\* BL; high bilirubin: \>2\* ULN, or if BL\>ULN then use \>4\* BL; high blood urea nitrogen (BUN): \>2\* BL; high creatinine: \>1.5\* BL (ULN 14.6 pg/mg. AST ULN=80 U/L; ALT ULN=34-47 U/L;creatinine ULN=14.6 pg/mg.
Time frame: Day 1 to Day 365, and including data up to 56 days post last dose of double-blind medication
Population: All Treated Population. Two participants in the ABA group and 3 participants in the PLA group were not evaluated for blood chemistry abnormalities due to data unavailability (missing data).
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Abatacept (ABA) | DB; Number of Participants With Blood Chemistry Laboratories Meeting Marked Abnormality (MA) Criteria | High AST (ULN=80 U/L) | 12 participants |
| Abatacept (ABA) | DB; Number of Participants With Blood Chemistry Laboratories Meeting Marked Abnormality (MA) Criteria | High ALT (ULN=34-47 U/L) | 16 participants |
| Abatacept (ABA) | DB; Number of Participants With Blood Chemistry Laboratories Meeting Marked Abnormality (MA) Criteria | High creatinine (ULN=14.6 pg/mg) | 41 participants |
| Placebo (PLA) | DB; Number of Participants With Blood Chemistry Laboratories Meeting Marked Abnormality (MA) Criteria | High AST (ULN=80 U/L) | 3 participants |
| Placebo (PLA) | DB; Number of Participants With Blood Chemistry Laboratories Meeting Marked Abnormality (MA) Criteria | High ALT (ULN=34-47 U/L) | 9 participants |
| Placebo (PLA) | DB; Number of Participants With Blood Chemistry Laboratories Meeting Marked Abnormality (MA) Criteria | High creatinine (ULN=14.6 pg/mg) | 29 participants |
DB; Number of Participants With Clinically Significant Physical Examination or Vital Signs Abnormalities
Physical examinations were performed at the discretion of the investigator and included breast examinations for female participants. Vital sign measurements were performed for participants before and after infusion of study medication at each visit and included seated systolic blood pressure, seated diastolic blood pressure, temperature, and heart rate. Abnormalities were determined to be clinically significant by the investigator.
Time frame: Days 1, 15, 29, 57, 85, 113, 141, 169, 197, 225, 253, 281, 309, 337. Vital signs were measured at these visits before and after study medication infusion.
Population: All Treated Population.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Abatacept (ABA) | DB; Number of Participants With Clinically Significant Physical Examination or Vital Signs Abnormalities | 0 participants |
| Placebo (PLA) | DB; Number of Participants With Clinically Significant Physical Examination or Vital Signs Abnormalities | 0 participants |
DB; Number of Participants With Hematology Laboratories Meeting Marked Abnormality Criteria
Upper Normal Limit (ULN), Lower Normal Limit (LLN), Baseline (BL). Marked abnormality criteria are: Hemoglobin (HGB): \>3 g/dL decrease from BL; Hematocrit: \<0.75 \* BL; Erythrocytes: \<0.75 \* BL; Platelets (PLT): \<0.67 \* LLN/\>1.5 \* ULN, or if BL \< LLN then use \<0.5 \* BL and \<100,000 mm\^3; Leukocytes: \<0.75 \* LLN/ \>1.25 \* ULN, or if BL\<LLN then use \<0.8 \* BL or \>ULN, or if BL\>ULN then use \>1.2 \* BL or \<LLN; neutrophils+bands: \<1.0 \* 10\^3 c/uL; eosinophils: \>0.750 \* 10\^3 c/uL; basophils: \> 400 mm\^3; monocytes: \>2000 mm\^3; lymphocytes: \<0.750 \* 10\^3 c/uL/ \>7.50 \* 10\^3 c/uL.
Time frame: Day 1 to Day 365, and including data up to 56 days post last dose of double-blind medication
Population: All Treated Population. One participant in each group was not evaluated for hematology abnormalities due to data unavailability (missing data).
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Abatacept (ABA) | DB; Number of Participants With Hematology Laboratories Meeting Marked Abnormality Criteria | Low erythrocytes (LLN=3.72-4.27 x10*6 c/uL) | 0 participants |
| Abatacept (ABA) | DB; Number of Participants With Hematology Laboratories Meeting Marked Abnormality Criteria | Low neutrophils + bands (LLN= 1.5-2.9*10^3 c/uL) | 16 participants |
| Abatacept (ABA) | DB; Number of Participants With Hematology Laboratories Meeting Marked Abnormality Criteria | High PLT (ULN=415-440*10^9 c/L) | 2 participants |
| Abatacept (ABA) | DB; Number of Participants With Hematology Laboratories Meeting Marked Abnormality Criteria | Low lymphocytes (LLN= 0.7-2.9*10^3 c/uL) | 0 participants |
| Abatacept (ABA) | DB; Number of Participants With Hematology Laboratories Meeting Marked Abnormality Criteria | Low HGB (LLN=1.5%) | 12 participants |
| Abatacept (ABA) | DB; Number of Participants With Hematology Laboratories Meeting Marked Abnormality Criteria | High lymphocytes (ULN= 4.5-13.3*10^3 c/uL) | 0 participants |
| Abatacept (ABA) | DB; Number of Participants With Hematology Laboratories Meeting Marked Abnormality Criteria | Low leukocytes (LLN= 4-9*10^3 c/uL) | 24 participants |
| Abatacept (ABA) | DB; Number of Participants With Hematology Laboratories Meeting Marked Abnormality Criteria | High monocytes (ULN=1-3.9*10^3 c/uL) | 0 participants |
| Abatacept (ABA) | DB; Number of Participants With Hematology Laboratories Meeting Marked Abnormality Criteria | Low PLT (LLN=140-157*10^9 c/L) | 7 participants |
| Abatacept (ABA) | DB; Number of Participants With Hematology Laboratories Meeting Marked Abnormality Criteria | High basophils (ULN= 0.6*10^3 c/uL) | 0 participants |
| Abatacept (ABA) | DB; Number of Participants With Hematology Laboratories Meeting Marked Abnormality Criteria | High leukocytes (ULN = 10.5-30*10^3 c/uL) | 70 participants |
| Abatacept (ABA) | DB; Number of Participants With Hematology Laboratories Meeting Marked Abnormality Criteria | High eosinophils (ULN= 1.5*10^3 c/uL) | 0 participants |
| Abatacept (ABA) | DB; Number of Participants With Hematology Laboratories Meeting Marked Abnormality Criteria | Low hematocrit (LLN=36%) | 9 participants |
| Placebo (PLA) | DB; Number of Participants With Hematology Laboratories Meeting Marked Abnormality Criteria | High eosinophils (ULN= 1.5*10^3 c/uL) | 0 participants |
| Placebo (PLA) | DB; Number of Participants With Hematology Laboratories Meeting Marked Abnormality Criteria | Low HGB (LLN=1.5%) | 14 participants |
| Placebo (PLA) | DB; Number of Participants With Hematology Laboratories Meeting Marked Abnormality Criteria | Low hematocrit (LLN=36%) | 12 participants |
| Placebo (PLA) | DB; Number of Participants With Hematology Laboratories Meeting Marked Abnormality Criteria | Low erythrocytes (LLN=3.72-4.27 x10*6 c/uL) | 0 participants |
| Placebo (PLA) | DB; Number of Participants With Hematology Laboratories Meeting Marked Abnormality Criteria | Low PLT (LLN=140-157*10^9 c/L) | 3 participants |
| Placebo (PLA) | DB; Number of Participants With Hematology Laboratories Meeting Marked Abnormality Criteria | High PLT (ULN=415-440*10^9 c/L) | 4 participants |
| Placebo (PLA) | DB; Number of Participants With Hematology Laboratories Meeting Marked Abnormality Criteria | Low leukocytes (LLN= 4-9*10^3 c/uL) | 12 participants |
| Placebo (PLA) | DB; Number of Participants With Hematology Laboratories Meeting Marked Abnormality Criteria | High leukocytes (ULN = 10.5-30*10^3 c/uL) | 57 participants |
| Placebo (PLA) | DB; Number of Participants With Hematology Laboratories Meeting Marked Abnormality Criteria | Low neutrophils + bands (LLN= 1.5-2.9*10^3 c/uL) | 9 participants |
| Placebo (PLA) | DB; Number of Participants With Hematology Laboratories Meeting Marked Abnormality Criteria | Low lymphocytes (LLN= 0.7-2.9*10^3 c/uL) | 0 participants |
| Placebo (PLA) | DB; Number of Participants With Hematology Laboratories Meeting Marked Abnormality Criteria | High lymphocytes (ULN= 4.5-13.3*10^3 c/uL) | 0 participants |
| Placebo (PLA) | DB; Number of Participants With Hematology Laboratories Meeting Marked Abnormality Criteria | High monocytes (ULN=1-3.9*10^3 c/uL) | 0 participants |
| Placebo (PLA) | DB; Number of Participants With Hematology Laboratories Meeting Marked Abnormality Criteria | High basophils (ULN= 0.6*10^3 c/uL) | 0 participants |
Double Blind Period (DB); Number of Participants With Death, Serious Adverse Events (SAEs), Related SAEs, SAEs Leading to Discontinuation, Adverse Events (AEs), Related AEs, or AEs Leading to Discontinuation
AE=any new untoward medical occurrence or worsening of a pre-existing medical condition which does not necessarily have a causal relationship with this treatment. SAE=any untoward medical occurrence that at any dose: results in death, is life-threatening, requires inpatient hospitalization or causes prolongation of existing hospitalization, results in persistent or significant disability/incapacity, is a congenital anomaly/birth defect, results in development of drug dependency or drug abuse, is an important medical event. Related SAE/AE = possibly, probably, or certainly related to study drug
Time frame: Day 1 to Day 365, and including data up to 56 days post last dose of double-blind medication
Population: All Treated Participants, all participants who received at least 1 dose of study medication
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Abatacept (ABA) | Double Blind Period (DB); Number of Participants With Death, Serious Adverse Events (SAEs), Related SAEs, SAEs Leading to Discontinuation, Adverse Events (AEs), Related AEs, or AEs Leading to Discontinuation | AEs Leading to Discontinuation | 52 participants |
| Abatacept (ABA) | Double Blind Period (DB); Number of Participants With Death, Serious Adverse Events (SAEs), Related SAEs, SAEs Leading to Discontinuation, Adverse Events (AEs), Related AEs, or AEs Leading to Discontinuation | Death | 5 participants |
| Abatacept (ABA) | Double Blind Period (DB); Number of Participants With Death, Serious Adverse Events (SAEs), Related SAEs, SAEs Leading to Discontinuation, Adverse Events (AEs), Related AEs, or AEs Leading to Discontinuation | SAEs | 123 participants |
| Abatacept (ABA) | Double Blind Period (DB); Number of Participants With Death, Serious Adverse Events (SAEs), Related SAEs, SAEs Leading to Discontinuation, Adverse Events (AEs), Related AEs, or AEs Leading to Discontinuation | Related SAEs | 23 participants |
| Abatacept (ABA) | Double Blind Period (DB); Number of Participants With Death, Serious Adverse Events (SAEs), Related SAEs, SAEs Leading to Discontinuation, Adverse Events (AEs), Related AEs, or AEs Leading to Discontinuation | SAEs Leading to Discontinuation | 23 participants |
| Abatacept (ABA) | Double Blind Period (DB); Number of Participants With Death, Serious Adverse Events (SAEs), Related SAEs, SAEs Leading to Discontinuation, Adverse Events (AEs), Related AEs, or AEs Leading to Discontinuation | AEs | 866 participants |
| Abatacept (ABA) | Double Blind Period (DB); Number of Participants With Death, Serious Adverse Events (SAEs), Related SAEs, SAEs Leading to Discontinuation, Adverse Events (AEs), Related AEs, or AEs Leading to Discontinuation | Related AEs | 534 participants |
| Placebo (PLA) | Double Blind Period (DB); Number of Participants With Death, Serious Adverse Events (SAEs), Related SAEs, SAEs Leading to Discontinuation, Adverse Events (AEs), Related AEs, or AEs Leading to Discontinuation | AEs Leading to Discontinuation | 20 participants |
| Placebo (PLA) | Double Blind Period (DB); Number of Participants With Death, Serious Adverse Events (SAEs), Related SAEs, SAEs Leading to Discontinuation, Adverse Events (AEs), Related AEs, or AEs Leading to Discontinuation | SAEs Leading to Discontinuation | 7 participants |
| Placebo (PLA) | Double Blind Period (DB); Number of Participants With Death, Serious Adverse Events (SAEs), Related SAEs, SAEs Leading to Discontinuation, Adverse Events (AEs), Related AEs, or AEs Leading to Discontinuation | Death | 4 participants |
| Placebo (PLA) | Double Blind Period (DB); Number of Participants With Death, Serious Adverse Events (SAEs), Related SAEs, SAEs Leading to Discontinuation, Adverse Events (AEs), Related AEs, or AEs Leading to Discontinuation | Related AEs | 239 participants |
| Placebo (PLA) | Double Blind Period (DB); Number of Participants With Death, Serious Adverse Events (SAEs), Related SAEs, SAEs Leading to Discontinuation, Adverse Events (AEs), Related AEs, or AEs Leading to Discontinuation | SAEs | 59 participants |
| Placebo (PLA) | Double Blind Period (DB); Number of Participants With Death, Serious Adverse Events (SAEs), Related SAEs, SAEs Leading to Discontinuation, Adverse Events (AEs), Related AEs, or AEs Leading to Discontinuation | AEs | 417 participants |
| Placebo (PLA) | Double Blind Period (DB); Number of Participants With Death, Serious Adverse Events (SAEs), Related SAEs, SAEs Leading to Discontinuation, Adverse Events (AEs), Related AEs, or AEs Leading to Discontinuation | Related SAEs | 13 participants |
OL; Number of Participants With AEs of Special Interest
AE=any new untoward medical occurrence or worsening of a pre-existing medical condition which does not necessarily have a causal relationship with this treatment. AEs of special interest are those AEs that may be associated with the use of immunomodulatory drugs, including all infections, serious infections, and opportunistic infections; autoimmune disorders; neoplasms; acute infusional AEs (pre-specified AEs occurring within 1 hour of start of infusion) and peri-infusional AEs (pre-specified AEs occurring within 24 hours of the start of infusion).
Time frame: Day 365 to Day 1821
Population: All Treated Participants, all participants who received at least 1 dose of study medication
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Abatacept (ABA) | OL; Number of Participants With AEs of Special Interest | Infections/Infestations | 957 participants |
| Abatacept (ABA) | OL; Number of Participants With AEs of Special Interest | Total Neoplasms | 168 participants |
| Abatacept (ABA) | OL; Number of Participants With AEs of Special Interest | Malignant Neoplasms | 56 participants |
| Abatacept (ABA) | OL; Number of Participants With AEs of Special Interest | Benign and Unspecified Neoplasms | 112 participants |
| Abatacept (ABA) | OL; Number of Participants With AEs of Special Interest | Pre-specified Autoimmune Disorders | 67 participants |
| Abatacept (ABA) | OL; Number of Participants With AEs of Special Interest | Pre-specified Acute Infusional AEs | 82 participants |
| Abatacept (ABA) | OL; Number of Participants With AEs of Special Interest | Pre-specified Peri-Infusional AEs | 219 participants |
OL; Number of Participants With Clinically Significant Physical Examination or Vital Signs Abnormalities
Physical examinations were performed at the discretion of the investigator and included breast examinations for female participants. Vital sign measurements were performed for participants before and after infusion of study medication at each visit and included seated systolic blood pressure, seated diastolic blood pressure, temperature, and heart rate. Abnormalities were determined to be clinically significant by the investigator.
Time frame: Days 365 to Day 1821
Population: All Treated Population.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Abatacept (ABA) | OL; Number of Participants With Clinically Significant Physical Examination or Vital Signs Abnormalities | 0 participants |
OL; Number of Participants With Electrolyte Laboratories Meeting Marked Abnormality Criteria
Marked abnormality criteria: Sodium (Na): \<0.95\*LLN/ \>1.05\*ULN, or if BL\<LLN then use \<0.95\* BL or \>ULN, or if BL\>ULN then use\>1.05\* BL or \<LLN; potassium (K): \<0.9\* LLN/\>1.1\*ULN, or if BL\<LLN then use \<0.9\* BL or \>ULN, or if BL\>ULN then use\>1.1\* BL or \<LLN; (Cl): \<0.9\* LLN/\>1.1\* ULN, or if BL\<LLN then use \<0.9\* BL or \>ULN, or if BL\>ULN then use\>1.1\* BL or \<LLN; calcium (Ca): \<0.8\* LLN/\>1.2\* ULN, or if BL\<LLN then use \<0.75\* BL or \>ULN, or if BL\>ULN then use\>1.25\* BL or \<LLN; phosphorous (P): \<0.75\* LLN/ \>1.25\* ULN, or if BL\<LLN then use 0.67\* BL or \>ULN, or if BL\>ULN then use\>1.33\* BL or \<LLN
Time frame: Day 365 to Day 1821, and including data up to 56 days post last dose of double-blind medication
Population: All Treated Population. One participant was not evaluated for electrolyte abnormalities.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Abatacept (ABA) | OL; Number of Participants With Electrolyte Laboratories Meeting Marked Abnormality Criteria | Low Na (LLN=135 mEq/L) | 16 participants |
| Abatacept (ABA) | OL; Number of Participants With Electrolyte Laboratories Meeting Marked Abnormality Criteria | High Na (ULN=148 mEq/L) | 1 participants |
| Abatacept (ABA) | OL; Number of Participants With Electrolyte Laboratories Meeting Marked Abnormality Criteria | Low K (LLN=3.5 mEq/L) | 77 participants |
| Abatacept (ABA) | OL; Number of Participants With Electrolyte Laboratories Meeting Marked Abnormality Criteria | High K (ULN=5.5 mEq/L) | 72 participants |
| Abatacept (ABA) | OL; Number of Participants With Electrolyte Laboratories Meeting Marked Abnormality Criteria | Low Cl (LLN= 96 mEq/L) | 5 participants |
| Abatacept (ABA) | OL; Number of Participants With Electrolyte Laboratories Meeting Marked Abnormality Criteria | High Cl (ULN=109 mEq/L) | 2 participants |
| Abatacept (ABA) | OL; Number of Participants With Electrolyte Laboratories Meeting Marked Abnormality Criteria | Low Ca (LLN=8.5 mg/dL) | 2 participants |
| Abatacept (ABA) | OL; Number of Participants With Electrolyte Laboratories Meeting Marked Abnormality Criteria | High Ca (ULN=11 mg/dL) | 0 participants |
| Abatacept (ABA) | OL; Number of Participants With Electrolyte Laboratories Meeting Marked Abnormality Criteria | Low P (LLN=2.5 mg/dL) | 17 participants |
| Abatacept (ABA) | OL; Number of Participants With Electrolyte Laboratories Meeting Marked Abnormality Criteria | High P (ULN 7.1 mg/dL) | 27 participants |
OL; Number of Participants With Hematology Laboratories Meeting Marked Abnormality Criteria
Upper Normal Limit (ULN), Lower Normal Limit (LLN), Baseline (BL). Marked abnormality criteria are: Hemoglobin (HGB): \>3 g/dL decrease from BL; Hematocrit: \<0.75 \* BL; Erythrocytes: \<0.75 \* BL; Platelets (PLT): \<0.67 \* LLN/\>1.5 \* ULN, or if BL \< LLN then use \<0.5 \* BL and \<100,000 mm\^3; Leukocytes: \<0.75 \* LLN/ \>1.25 \* ULN, or if BL\<LLN then use \<0.8 \* BL or \>ULN, or if BL\>ULN then use \>1.2 \* BL or \<LLN; neutrophils+bands: \<1.0 \* 10\^3 c/uL; eosinophils: \>0.750 \* 10\^3 c/uL; basophils: \> 400 mm\^3; monocytes: \>2000 mm\^3; lymphocytes: \<0.750 \* 10\^3 c/uL/ \>7.50 \* 10\^3 c/uL.
Time frame: Day 365 to Day 1821, and including data up to 56 days post last dose of double-blind medication
Population: All Treated Population.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Abatacept (ABA) | OL; Number of Participants With Hematology Laboratories Meeting Marked Abnormality Criteria | Low HGB (LLN=1.5%) | 70 participants |
| Abatacept (ABA) | OL; Number of Participants With Hematology Laboratories Meeting Marked Abnormality Criteria | Low hematocrit (LLN=36%) | 53 participants |
| Abatacept (ABA) | OL; Number of Participants With Hematology Laboratories Meeting Marked Abnormality Criteria | Erythrocytes (LLN=3.72-4.27 x10*6 c/uL) | 25 participants |
| Abatacept (ABA) | OL; Number of Participants With Hematology Laboratories Meeting Marked Abnormality Criteria | Low PLT (LLN=140-157*10^9 c/L) | 23 participants |
| Abatacept (ABA) | OL; Number of Participants With Hematology Laboratories Meeting Marked Abnormality Criteria | High PLT (ULN=415-440*10^9 c/L) | 10 participants |
| Abatacept (ABA) | OL; Number of Participants With Hematology Laboratories Meeting Marked Abnormality Criteria | Low leukocytes (LLN= 4-9*10^3 c/uL) | 110 participants |
| Abatacept (ABA) | OL; Number of Participants With Hematology Laboratories Meeting Marked Abnormality Criteria | High leukocytes (ULN = 10.5-30*10^3 c/uL) | 162 participants |
| Abatacept (ABA) | OL; Number of Participants With Hematology Laboratories Meeting Marked Abnormality Criteria | Low neutrophils + bands (LLN= 1.5-2.9*10^3 c/uL) | 31 participants |
| Abatacept (ABA) | OL; Number of Participants With Hematology Laboratories Meeting Marked Abnormality Criteria | Low lymphocytes (LLN= 0.7-2.9*10^3 c/uL) | 220 participants |
| Abatacept (ABA) | OL; Number of Participants With Hematology Laboratories Meeting Marked Abnormality Criteria | High lymphocytes (ULN= 4.5-13.3*10^3 c/uL) | 5 participants |
| Abatacept (ABA) | OL; Number of Participants With Hematology Laboratories Meeting Marked Abnormality Criteria | High monocytes (ULN=1-3.9*10^3 c/uL) | 11 participants |
| Abatacept (ABA) | OL; Number of Participants With Hematology Laboratories Meeting Marked Abnormality Criteria | High basophils (ULN= 0.6*10^3 c/uL) | 4 participants |
| Abatacept (ABA) | OL; Number of Participants With Hematology Laboratories Meeting Marked Abnormality Criteria | High eosinophils (ULN= 1.5*10^3 c/uL) | 151 participants |
OL; Number of Participants With Liver Function Laboratories Meeting Marked Abnormality Criteria
Marked abnormality criteria: Alkaline phosphatase (ALP): \>2\* ULN, or if BL\>ULN then use \>3\* BL; aspartate aminotransferase (AST): \>3\* ULN, or if BL\>ULN then use \>4\* BL; alanine aminotransferase (ALT): \>3\* ULN, or if BL\>ULN then use \>4\* BL; G-Glutamyl transferase (GGT): \>2\* ULN, or if BL\>ULN then use \>3\* BL; Bilirubin: \>2\* ULN, or if BL\>ULN then use \>4\* BL; blood urea nitrogen (BUN): \>2\* BL; creatinine: \>1.5\* BL
Time frame: Day 365 to Day 1821, and including data up to 56 days post last dose of double-blind medication
Population: All Treated Population. One participant was not evaluated for liver function abnormalities.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Abatacept (ABA) | OL; Number of Participants With Liver Function Laboratories Meeting Marked Abnormality Criteria | High creatinine (ULN=14.6 pg/mg) | 204 participants |
| Abatacept (ABA) | OL; Number of Participants With Liver Function Laboratories Meeting Marked Abnormality Criteria | High bilirubin (ULN=0.3 mg/dL) | 9 participants |
| Abatacept (ABA) | OL; Number of Participants With Liver Function Laboratories Meeting Marked Abnormality Criteria | High BUN (normal=4-25 mg/dL) | 108 participants |
| Abatacept (ABA) | OL; Number of Participants With Liver Function Laboratories Meeting Marked Abnormality Criteria | High ALP (ULN=150 U/L) | 12 participants |
| Abatacept (ABA) | OL; Number of Participants With Liver Function Laboratories Meeting Marked Abnormality Criteria | High AST (ULN=80 U/L) | 38 participants |
| Abatacept (ABA) | OL; Number of Participants With Liver Function Laboratories Meeting Marked Abnormality Criteria | High ALT (ULN=34-47 U/L) | 54 participants |
| Abatacept (ABA) | OL; Number of Participants With Liver Function Laboratories Meeting Marked Abnormality Criteria | High GGT (ULN=43-54 U/L) | 91 participants |
OL; Number of Participants With Other Chemistry and Urinalysis Laboratories Meeting Marked Abnormality Criteria
MA criteria: serum glucose (Glu): \<65 mg/dL/\>220 mg/dL;fasting serum Glu: \<0.8\* LLN/\>1.5\*ULN,or if BL\<LLN then use 0.8\*BL or \>ULN,or if BL\>ULN then use \>2.0\*BL or \<LLN;total protein: \<0.9\*LLN/\>1.1\*ULN,or if BL\<LLN then use \<0.9\*BL or \>UNL,or if BL\>UNL then use \>1.1\*BL or \<LLN; albumin: \<0.9\*LLN,or if BL\<LLN then use \<0.75 BL;uric acid: \>1.5\*ULN,or if BL\>ULN then use \>2\*BL. Urinalysis (Urine protein,urine Glu,urine blood,leukocyte esterase,Red Blood Cells \[RBCs\], White Blood Cells \[WBCs\]):Use ≥2 when BL value missing or when pre-dose=0 or 0.5; use ≥3 when pre-dose=1, use ≥4 when pre-dose=2 or 3
Time frame: Day 365 to Day 1821, and including data up to 56 days post last dose of double-blind medication
Population: All Treated Population. N=Number of Participants Analyzed, n=number of participants with measurements at time point
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Abatacept (ABA) | OL; Number of Participants With Other Chemistry and Urinalysis Laboratories Meeting Marked Abnormality Criteria | Low Glu, n=1184 | 207 participants |
| Abatacept (ABA) | OL; Number of Participants With Other Chemistry and Urinalysis Laboratories Meeting Marked Abnormality Criteria | High Glu, n=1184 | 61 participants |
| Abatacept (ABA) | OL; Number of Participants With Other Chemistry and Urinalysis Laboratories Meeting Marked Abnormality Criteria | Low fasting Glu, n=647 (LLN=65 mg/dL) | 647 participants |
| Abatacept (ABA) | OL; Number of Participants With Other Chemistry and Urinalysis Laboratories Meeting Marked Abnormality Criteria | High fasting Glu, n=647 (ULN=115 mg/dL) | 41 participants |
| Abatacept (ABA) | OL; Number of Participants With Other Chemistry and Urinalysis Laboratories Meeting Marked Abnormality Criteria | Low protein, n=1183 (LLN=6 g/dL) | 12 participants |
| Abatacept (ABA) | OL; Number of Participants With Other Chemistry and Urinalysis Laboratories Meeting Marked Abnormality Criteria | High protein, n=1183 (ULN=8.5 g/dL) | 2 participants |
| Abatacept (ABA) | OL; Number of Participants With Other Chemistry and Urinalysis Laboratories Meeting Marked Abnormality Criteria | Low albumin, n=1183 (LLN=3.5 g/dL) | 40 participants |
| Abatacept (ABA) | OL; Number of Participants With Other Chemistry and Urinalysis Laboratories Meeting Marked Abnormality Criteria | High uric acid, n=1183 (ULN=8.7 mg/dL) | 19 participants |
| Abatacept (ABA) | OL; Number of Participants With Other Chemistry and Urinalysis Laboratories Meeting Marked Abnormality Criteria | High urine protein, n=1184 (normal=trace) | 125 participants |
| Abatacept (ABA) | OL; Number of Participants With Other Chemistry and Urinalysis Laboratories Meeting Marked Abnormality Criteria | High urine glucose, n=1184 (normal=negative) | 51 participants |
| Abatacept (ABA) | OL; Number of Participants With Other Chemistry and Urinalysis Laboratories Meeting Marked Abnormality Criteria | High urine ketones, n=33 (normal=negative) | 0 participants |
| Abatacept (ABA) | OL; Number of Participants With Other Chemistry and Urinalysis Laboratories Meeting Marked Abnormality Criteria | High urine blood, n=1184 (normal=negative) | 310 participants |
| Abatacept (ABA) | OL; Number of Participants With Other Chemistry and Urinalysis Laboratories Meeting Marked Abnormality Criteria | High leukocyte esterase, n=32 | 12 participants |
| Abatacept (ABA) | OL; Number of Participants With Other Chemistry and Urinalysis Laboratories Meeting Marked Abnormality Criteria | High urine WBC, n=852 | 429 participants |
| Abatacept (ABA) | OL; Number of Participants With Other Chemistry and Urinalysis Laboratories Meeting Marked Abnormality Criteria | High urine RBC, n=852 | 403 participants |
Open Label Period (OL); Number of Participants With Death, Serious Adverse Events (SAEs), Related SAEs, SAEs Leading to Discontinuation, Adverse Events (AEs), Related AEs, or AEs Leading to Discontinuation
AE=any new untoward medical occurrence or worsening of a pre-existing medical condition which does not necessarily have a causal relationship with this treatment. SAE=any untoward medical occurrence that at any dose: results in death, is life-threatening, requires inpatient hospitalization or causes prolongation of existing hospitalization, results in persistent or significant disability/incapacity, is a congenital anomaly/birth defect, results in development of drug dependency or drug abuse, is an important medical event. Related SAE/AE = possibly, probably, or certainly related to study drug
Time frame: Day 365 to Day 1,821
Population: All Treated Participants
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Abatacept (ABA) | Open Label Period (OL); Number of Participants With Death, Serious Adverse Events (SAEs), Related SAEs, SAEs Leading to Discontinuation, Adverse Events (AEs), Related AEs, or AEs Leading to Discontinuation | Death | 32 participants |
| Abatacept (ABA) | Open Label Period (OL); Number of Participants With Death, Serious Adverse Events (SAEs), Related SAEs, SAEs Leading to Discontinuation, Adverse Events (AEs), Related AEs, or AEs Leading to Discontinuation | SAEs | 425 participants |
| Abatacept (ABA) | Open Label Period (OL); Number of Participants With Death, Serious Adverse Events (SAEs), Related SAEs, SAEs Leading to Discontinuation, Adverse Events (AEs), Related AEs, or AEs Leading to Discontinuation | Related SAEs | 124 participants |
| Abatacept (ABA) | Open Label Period (OL); Number of Participants With Death, Serious Adverse Events (SAEs), Related SAEs, SAEs Leading to Discontinuation, Adverse Events (AEs), Related AEs, or AEs Leading to Discontinuation | SAEs Leading to Discontinuation | 70 participants |
| Abatacept (ABA) | Open Label Period (OL); Number of Participants With Death, Serious Adverse Events (SAEs), Related SAEs, SAEs Leading to Discontinuation, Adverse Events (AEs), Related AEs, or AEs Leading to Discontinuation | AEs | 1123 participants |
| Abatacept (ABA) | Open Label Period (OL); Number of Participants With Death, Serious Adverse Events (SAEs), Related SAEs, SAEs Leading to Discontinuation, Adverse Events (AEs), Related AEs, or AEs Leading to Discontinuation | Related AEs | 737 participants |
| Abatacept (ABA) | Open Label Period (OL); Number of Participants With Death, Serious Adverse Events (SAEs), Related SAEs, SAEs Leading to Discontinuation, Adverse Events (AEs), Related AEs, or AEs Leading to Discontinuation | AEs Leading to Discontinuation | 103 participants |
DB; Number of Participants With Positive Anti-Abatacept or Anti-Cytotoxic T-Lymphocyte Antigen 4 (CTLA4) Responses by ELISA
Serum samples from all treated adult participants with active rheumatoid arthritis were screened for the presence of drug-specific antibodies using ELISA. Immunogenicity was defined as the presence of a positive anti-abatacept or anti-CTLA4 antibody.
Time frame: Days 1, 15, 29, 57, 85, 113, 141, 169, 197, 225, 253, 281, 309, 337
Population: All DB participants treated on study who received at least 1 dose of abatacept and had antibody samples collected at baseline and at least 1 post-baseline visit. 68 participants were not evaluated for anti-abatacept anti-bodies on study.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Abatacept (ABA) | DB; Number of Participants With Positive Anti-Abatacept or Anti-Cytotoxic T-Lymphocyte Antigen 4 (CTLA4) Responses by ELISA | Anti-abatacept antibodies (n=1228) | 66 participants |
| Abatacept (ABA) | DB; Number of Participants With Positive Anti-Abatacept or Anti-Cytotoxic T-Lymphocyte Antigen 4 (CTLA4) Responses by ELISA | Anti-CTLA4 antibodies (n=1296) | 48 participants |
| Abatacept (ABA) | DB; Number of Participants With Positive Anti-Abatacept or Anti-Cytotoxic T-Lymphocyte Antigen 4 (CTLA4) Responses by ELISA | Total antibodies (n=1296) | 107 participants |
DB; Number of Participants With Positive Anti-Abatacept or Anti-Cytotoxic T-Lymphocyte Antigen 4 (CTLA4) Responses by Enzyme-Linked Immunosorbant Assay (ELISA)
Serum samples from all treated adult participants with active rheumatoid arthritis (RA) were screened for the presence of drug-specific antibodies using ELISA. Immunogenicity was defined as the presence of a positive anti-abatacept or anti-CTLA4 antibody.
Time frame: Days 1, 29, 57, 85, 113,169, 281, 365
Population: All participants treated during DB who received at least 1 dose of abatacept and had antibody samples collected at baseline and at least 1 post-baseline visit. 561 participants were not evaluated for anti-abatacept anti-bodies during the DB.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Abatacept (ABA) | DB; Number of Participants With Positive Anti-Abatacept or Anti-Cytotoxic T-Lymphocyte Antigen 4 (CTLA4) Responses by Enzyme-Linked Immunosorbant Assay (ELISA) | Anti-abatacept antibodies | 13 participants |
| Abatacept (ABA) | DB; Number of Participants With Positive Anti-Abatacept or Anti-Cytotoxic T-Lymphocyte Antigen 4 (CTLA4) Responses by Enzyme-Linked Immunosorbant Assay (ELISA) | Anti-CTLA4 antibodies | 9 participants |
| Abatacept (ABA) | DB; Number of Participants With Positive Anti-Abatacept or Anti-Cytotoxic T-Lymphocyte Antigen 4 (CTLA4) Responses by Enzyme-Linked Immunosorbant Assay (ELISA) | Total antibodies | 22 participants |