Trial Outcomes & Findings for Abatacept and Infliximab in Combination With Methotrexate in Subjects With Rheumatoid Arthritis (NCT NCT00095147)

NCT ID: NCT00095147

Last Updated: 2015-03-24

Results Overview

The DAS28 is a continuous disease measure which is a composite of 4 variables: the 28 tender joint count, the 28 swollen joint count, ESR or C-reactive protein (CRP), and participant assessment of disease activity measure on a visual analogue scale. The DAS28 has numeric thresholds that define high disease activity (\> 5.1), low disease activity (\< 3.2) and remission (\< 2.6). A clinically significant response is a decrease in DAS28 score of \>1.2 from baseline.

Recruitment status

COMPLETED

Study phase

PHASE3

Target enrollment

431 participants

Primary outcome timeframe

Baseline (Day 1), 6 months (Day 197)

Results posted on

2015-03-24

Participant Flow

748 participants enrolled in this study; 317 participants were not randomized or treated. 384 participants completed the double-blind period; 12 participants did not enter the open-label period.

Participant milestones

Participant milestones
Measure
Abatacept (ABA) + Methotrexate (MTX) [Double-blind (DB)]
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
Infliximab (INF) + MTX [DB]
Infliximab was given 3 mg/kg IV (approved labeled dose) on Days 1, 15, 43, 85 and every 56 days thereafter for a total of 8 doses. All participants received a stable dose of MTX (minimum 15 mg weekly)
Placebo (PLA) + MTX [DB]
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA Switched to ABA + MTX [DB]
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly). After placebo treatment from Day 1-197, participants were reallocated to receive abatacept (weight based) plus a stable dose of MTX (minimum 15 mg weekly).
ABA + MTX [Open-label (OL)]
All participants received ABA at a weight-tiered dose of 10 mg/kg plus a stable dose of MTX (minimum 15 mg weekly).
Double-blind Period 1 (Days 1-197)
STARTED
156
165
110
0
0
Double-blind Period 1 (Days 1-197)
COMPLETED
147
152
107
0
0
Double-blind Period 1 (Days 1-197)
NOT COMPLETED
9
13
3
0
0
Double-blind Period 2 (Days 198-365)
STARTED
147
152
0
107
0
Double-blind Period 2 (Days 198-365)
COMPLETED
139
141
0
104
0
Double-blind Period 2 (Days 198-365)
NOT COMPLETED
8
11
0
3
0
Long-term Extension Period
STARTED
0
0
0
0
372
Long-term Extension Period
COMPLETED
0
0
0
0
327
Long-term Extension Period
NOT COMPLETED
0
0
0
0
45

Reasons for withdrawal

Reasons for withdrawal
Measure
Abatacept (ABA) + Methotrexate (MTX) [Double-blind (DB)]
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
Infliximab (INF) + MTX [DB]
Infliximab was given 3 mg/kg IV (approved labeled dose) on Days 1, 15, 43, 85 and every 56 days thereafter for a total of 8 doses. All participants received a stable dose of MTX (minimum 15 mg weekly)
Placebo (PLA) + MTX [DB]
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA Switched to ABA + MTX [DB]
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly). After placebo treatment from Day 1-197, participants were reallocated to receive abatacept (weight based) plus a stable dose of MTX (minimum 15 mg weekly).
ABA + MTX [Open-label (OL)]
All participants received ABA at a weight-tiered dose of 10 mg/kg plus a stable dose of MTX (minimum 15 mg weekly).
Double-blind Period 1 (Days 1-197)
Death
1
0
0
0
0
Double-blind Period 1 (Days 1-197)
Adverse Event
2
8
1
0
0
Double-blind Period 1 (Days 1-197)
Lack of Efficacy
2
2
1
0
0
Double-blind Period 1 (Days 1-197)
Lost to Follow-up
2
2
0
0
0
Double-blind Period 1 (Days 1-197)
Withdrawal of consent
1
0
1
0
0
Double-blind Period 1 (Days 1-197)
Pregnancy
1
1
0
0
0
Double-blind Period 2 (Days 198-365)
Death
0
1
0
1
0
Double-blind Period 2 (Days 198-365)
Adverse Event
2
4
0
0
0
Double-blind Period 2 (Days 198-365)
Lack of Efficacy
2
4
0
1
0
Double-blind Period 2 (Days 198-365)
Withdrawal of consent
3
2
0
0
0
Double-blind Period 2 (Days 198-365)
Participant relocation
1
0
0
1
0
Long-term Extension Period
Death
0
0
0
0
3
Long-term Extension Period
Adverse Event
0
0
0
0
11
Long-term Extension Period
Lack of Efficacy
0
0
0
0
9
Long-term Extension Period
Lost to Follow-up
0
0
0
0
6
Long-term Extension Period
Withdrawal of consent
0
0
0
0
12
Long-term Extension Period
Pregnancy
0
0
0
0
1
Long-term Extension Period
No longer meets study criteria
0
0
0
0
1
Long-term Extension Period
Participant chose to use Revellex
0
0
0
0
1
Long-term Extension Period
Leaving country
0
0
0
0
1

Baseline Characteristics

Abatacept and Infliximab in Combination With Methotrexate in Subjects With Rheumatoid Arthritis

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
ABA + MTX [DB]
n=156 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
INF + MTX [DB]
n=165 Participants
Infliximab was given 3 mg/kg IV (approved labeled dose) on Days 1, 15, 43, 85 and every 56 days thereafter for a total of 8 doses. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
n=110 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
Total
n=431 Participants
Total of all reporting groups
Age, Continuous
49.0 years
STANDARD_DEVIATION 12.5 • n=5 Participants
49.1 years
STANDARD_DEVIATION 12.0 • n=7 Participants
49.4 years
STANDARD_DEVIATION 11.5 • n=5 Participants
49.1 years
STANDARD_DEVIATION 12.0 • n=4 Participants
Sex: Female, Male
Female
130 Participants
n=5 Participants
136 Participants
n=7 Participants
96 Participants
n=5 Participants
362 Participants
n=4 Participants
Sex: Female, Male
Male
26 Participants
n=5 Participants
29 Participants
n=7 Participants
14 Participants
n=5 Participants
69 Participants
n=4 Participants
Baseline Disease Activity Score (DAS) 28 (Erythrocyte Sedimentation Rate [ESR])
6.9 units on a scale
STANDARD_DEVIATION 1.0 • n=5 Participants
6.8 units on a scale
STANDARD_DEVIATION 0.9 • n=7 Participants
6.8 units on a scale
STANDARD_DEVIATION 1.0 • n=5 Participants
6.8 units on a scale
STANDARD_DEVIATION 1.0 • n=4 Participants

PRIMARY outcome

Timeframe: Baseline (Day 1), 6 months (Day 197)

Population: The Intent-to-Treat (ITT) analysis population was defined to include all participants randomized into the study who received study medication. Participants were grouped according to the treatment or treatment regimen to which they were randomized. All participants who were randomized but never received study medication were excluded.

The DAS28 is a continuous disease measure which is a composite of 4 variables: the 28 tender joint count, the 28 swollen joint count, ESR or C-reactive protein (CRP), and participant assessment of disease activity measure on a visual analogue scale. The DAS28 has numeric thresholds that define high disease activity (\> 5.1), low disease activity (\< 3.2) and remission (\< 2.6). A clinically significant response is a decrease in DAS28 score of \>1.2 from baseline.

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=150 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
n=102 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
DB; Adjusted Mean Change From Baseline to Day 197 in Disease Activity Score (DAS) 28 Score (Erythrocyte Sedimentation Rate [ESR]) For ABA Versus PLA (Last Observation Carried Forward [LOCF] Analysis)
-2.53 units on a scale
Standard Error 0.12
-1.48 units on a scale
Standard Error 0.15

PRIMARY outcome

Timeframe: From beginning of OL (Day 366) through end of OL (range from 1.9 months to 42.3 months)

Population: All Treated Population, all participants who entered the open-label period and received at least one dose of abatacept at any time during this period.

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.

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=372 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
OL; Number of Participants With Death, Serious Adverse Events (SAEs), Related SAEs, SAEs Leading to Discontinuation, Adverse Events (AEs), Related AEs, and AEs Leading to Discontinuation
Deaths
3 participants
OL; Number of Participants With Death, Serious Adverse Events (SAEs), Related SAEs, SAEs Leading to Discontinuation, Adverse Events (AEs), Related AEs, and AEs Leading to Discontinuation
SAEs
90 participants
OL; Number of Participants With Death, Serious Adverse Events (SAEs), Related SAEs, SAEs Leading to Discontinuation, Adverse Events (AEs), Related AEs, and AEs Leading to Discontinuation
Related SAEs
12 participants
OL; Number of Participants With Death, Serious Adverse Events (SAEs), Related SAEs, SAEs Leading to Discontinuation, Adverse Events (AEs), Related AEs, and AEs Leading to Discontinuation
SAEs Leading to Discontinuation
5 participants
OL; Number of Participants With Death, Serious Adverse Events (SAEs), Related SAEs, SAEs Leading to Discontinuation, Adverse Events (AEs), Related AEs, and AEs Leading to Discontinuation
AEs
349 participants
OL; Number of Participants With Death, Serious Adverse Events (SAEs), Related SAEs, SAEs Leading to Discontinuation, Adverse Events (AEs), Related AEs, and AEs Leading to Discontinuation
Related AEs
165 participants
OL; Number of Participants With Death, Serious Adverse Events (SAEs), Related SAEs, SAEs Leading to Discontinuation, Adverse Events (AEs), Related AEs, and AEs Leading to Discontinuation
AEs Leading to discontinuation
10 participants

PRIMARY outcome

Timeframe: From beginning of OL (Day 366) through end of OL (range from 1.9 months to 42.3 months)

Population: All Treated Population, all participants who entered the open-label period and received at least one dose of abatacept at any time during this period.

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, autoimmune disorders; malignancies; and acute infusional AEs (pre-specified AEs occurring within 1 hour of start of infusion).

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=372 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
OL; Number of Participants With AEs of Special Interest
Infections
277 participants
OL; Number of Participants With AEs of Special Interest
Malignant neoplasms
3 participants
OL; Number of Participants With AEs of Special Interest
Benign and unspecified neoplasms
18 participants
OL; Number of Participants With AEs of Special Interest
Prespecified autoimmune symptoms and disorders
13 participants
OL; Number of Participants With AEs of Special Interest
Pre-specified peri-infusional AEs
50 participants
OL; Number of Participants With AEs of Special Interest
Pre-specified acute infusional AEs
28 participants

PRIMARY outcome

Timeframe: From Day 366 through end of OL (range from 1.9 months to 42.3 months)

Population: All Treated Population, all participants who entered the open-label period and received at least one dose of abatacept at any time during this period.

High=greater than Upper Normal Limit (ULN), Low=lower than Lower Normal Limit (LLN). LLN/ULN= Hemoglobin (HGB): \>3 g/dL decrease from Baseline (BL); Hematocrit: \<0.75 x BL; Erythrocytes: \<0.75 x BL; Platelets (PLT): \<0.67 x LLN/\>1.5 x ULN; Leukocytes: \<0.75 x LLN/ \>1.25 x ULN; neutrophils+bands: \<1.0 x 10\^3 c/uL; lymphocytes: \<0.750 x 10\^3 c/uL/ \>7.50 x 10\^3 c/uL; monocytes: \>2000 mm3; eosinophils: \>0.750 x 10\^3 c/uL;

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=372 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
OL; Number of Participants With Select Hematologic Laboratory Abnormalities
Low HGB (>3g/dL decrease from BL), n=372
9 participants
OL; Number of Participants With Select Hematologic Laboratory Abnormalities
Low hematocrit (< 0.75 x BL), n=372
7 participants
OL; Number of Participants With Select Hematologic Laboratory Abnormalities
Low erythrocytes (<0.75 x BL), n=372
6 participants
OL; Number of Participants With Select Hematologic Laboratory Abnormalities
Low PLT (<0.67 x LLN), n=370
2 participants
OL; Number of Participants With Select Hematologic Laboratory Abnormalities
High leukocytes (>1.25 x ULN), n=372
29 participants
OL; Number of Participants With Select Hematologic Laboratory Abnormalities
Low neutrophils + bands (<1.0 x 10^3 c/uL), n=372
1 participants
OL; Number of Participants With Select Hematologic Laboratory Abnormalities
Low lymphocytes (<0.75 x 10^3 c/uL), n=372
12 participants
OL; Number of Participants With Select Hematologic Laboratory Abnormalities
High monocytes (>2000/mm^3), n=372
3 participants
OL; Number of Participants With Select Hematologic Laboratory Abnormalities
High eosinophils (>0.750 x 10^3 c/uL), n=372
15 participants

PRIMARY outcome

Timeframe: From Day 366 through end of OL (range from 1.9 months to 42.3 months)

Population: All Treated Population, all participants who entered the open-label period and received at least one dose of abatacept at any time during this period.

Low=lower than LLN, High=greater than ULN. LLN/ULN= Alkaline phosphatase (ALP): \>2 x ULN; aspartate aminotransferase (AST): \>3 x ULN; alanine aminotransferase (ALT): \>3 x ULN; G-Glutamyl transferase (GGT): \>2 x ULN; Bilirubin: \>2 x ULN; blood urea nitrogen (BUN): \>2 x BL; creatinine: \>4 x BL

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=371 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
OL; Number of Participants With Select Blood Chemistry Laboratory Abnormalities
High ALP (>2 x ULN)
1 participants
OL; Number of Participants With Select Blood Chemistry Laboratory Abnormalities
High AST (>3 x ULN)
4 participants
OL; Number of Participants With Select Blood Chemistry Laboratory Abnormalities
High ALT (>3 x ULN)
11 participants
OL; Number of Participants With Select Blood Chemistry Laboratory Abnormalities
High GGT (>2 x ULN)
16 participants
OL; Number of Participants With Select Blood Chemistry Laboratory Abnormalities
High total bilirubin (>2 x ULN)
1 participants
OL; Number of Participants With Select Blood Chemistry Laboratory Abnormalities
High BUN (>2 x BL)
17 participants
OL; Number of Participants With Select Blood Chemistry Laboratory Abnormalities
High creatinine (>1.5 increase from BL)
44 participants

PRIMARY outcome

Timeframe: Baseline (Day 1), Day 365

Population: Number of Participants Analyzed=All Treated Population, all participants who entered the open-label period and received at least one dose of abatacept at any time during this period. Treatment groups represent treatment received in the DB period. n=number of participants with data available.

Hemoglobin (HGB): \>3 g/dL decrease from BL; total protein: \< 0.9 x LLN, \>1.1 x ULN; albumin:\<0.9 x LLN

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=131 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
n=136 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
n=104 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
OL; Mean Change From Baseline to Day 365 in Hemoglobin, Total Protein, and Albumin
HGB (n=131, n=135, n=103)
0.53 g/dL
Standard Error 0.09
0.24 g/dL
Standard Error 0.09
0.43 g/dL
Standard Error 0.09
OL; Mean Change From Baseline to Day 365 in Hemoglobin, Total Protein, and Albumin
Total protein (n=131, n=136, n=104)
-0.09 g/dL
Standard Error 0.04
0.11 g/dL
Standard Error 0.04
-0.12 g/dL
Standard Error 0.04
OL; Mean Change From Baseline to Day 365 in Hemoglobin, Total Protein, and Albumin
Albumin (n=131, n=136, n=104)
0.12 g/dL
Standard Error 0.03
0.00 g/dL
Standard Error 0.03
0.05 g/dL
Standard Error 0.03

PRIMARY outcome

Timeframe: Baseline (Day 1), Day 365

Population: Number of Participants Analyzed=All Treated Population, all participants who entered the open-label period and received at least one dose of abatacept at any time during this period. Treatment groups represent treatment received in the DB period. n=number of participants with data available.

Platelets (PLT): \<0.67 x LLN, \>1.5 x ULN

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=129 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
n=129 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
n=102 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
OL; Mean Change From Baseline to Day 365 in Platelets
-42.4 10^9 c/L
Standard Error 5.20
-35.5 10^9 c/L
Standard Error 6.93
-28.4 10^9 c/L
Standard Error 6.75

PRIMARY outcome

Timeframe: Baseline (Day 1), Day 365

Population: Number of Participants Analyzed=All Treated Population, all participants who entered the open-label period and received at least one dose of abatacept at any time during this period. Treatment groups represent treatment received in the DB period. n=number of participants with data available.

Hematocrit: \<0.75 x BL

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=129 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
n=134 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
n=102 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
OL; Mean Change From Baseline to Day 365 in Hematocrit
1.44 percentage red blood cells
Standard Error 0.29
0.51 percentage red blood cells
Standard Error 0.27
1.03 percentage red blood cells
Standard Error 0.27

PRIMARY outcome

Timeframe: Baseline (Day 1), Day 365

Population: Number of Participants Analyzed=All Treated Population, all participants who entered the open-label period and received at least one dose of abatacept at any time during this period. Treatment groups represent treatment received in the DB period. n=number of participants with data available.

Leukocytes: \<0.75 x LLN, \>1.25 x ULN; neutrophils+bands: \<1.0 x 10\^3 c/uL; eosinophils: \>0.750 x 10\^3 c/uL; basophils: \> 400 mm3; monocytes: \>2000 mm3; lymphocytes: \<0.750 x 10\^3 c/uL, \>7.50 x 10\^3 c/uL.

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=131 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
n=134 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
n=104 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
OL; Mean Change From Baseline to Day 365 in White Blood Cells
Leukocytes (n=131, n=134, n=103)
-0.95 10^3 c/uL
Standard Error 0.23
-0.90 10^3 c/uL
Standard Error 0.21
-0.84 10^3 c/uL
Standard Error 0.23
OL; Mean Change From Baseline to Day 365 in White Blood Cells
Neutrophils + bands (n=130, n=130, n=104)
-0.91 10^3 c/uL
Standard Error 0.20
-1.14 10^3 c/uL
Standard Error 0.20
-1.05 10^3 c/uL
Standard Error 0.22
OL; Mean Change From Baseline to Day 365 in White Blood Cells
Basophils (n=130, n=130, n=101)
-0.01 10^3 c/uL
Standard Error 0.00
0.00 10^3 c/uL
Standard Error 0.00
0.00 10^3 c/uL
Standard Error 0.00
OL; Mean Change From Baseline to Day 365 in White Blood Cells
Monocytes (n=130, n=130, n=101)
-0.01 10^3 c/uL
Standard Error 0.02
-0.01 10^3 c/uL
Standard Error 0.02
0.02 10^3 c/uL
Standard Error 0.02
OL; Mean Change From Baseline to Day 365 in White Blood Cells
Eosinophils (n=130, n=130, n=101)
-0.04 10^3 c/uL
Standard Error 0.01
-0.02 10^3 c/uL
Standard Error 0.02
-0.03 10^3 c/uL
Standard Error 0.01
OL; Mean Change From Baseline to Day 365 in White Blood Cells
Lymphocytes (n=130, n=130, n=101)
0.03 10^3 c/uL
Standard Error 0.07
0.24 10^3 c/uL
Standard Error 0.06
0.22 10^3 c/uL
Standard Error 0.08

PRIMARY outcome

Timeframe: Baseline (Day 1), Day 365

Population: Number of Participants Analyzed=All Treated Population, all participants who entered the open-label period and received at least one dose of abatacept at any time during this period. Treatment groups represent treatment received in the DB period. n=number of participants with data available.

Erythrocytes: \<0.75 x BL

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=131 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
n=135 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
n=103 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
OL; Mean Change From Baseline to Day 365 in Erythrocytes
0.09 10^6 c/uL
Standard Error 0.03
0.00 10^6 c/uL
Standard Error 0.03
0.006 10^6 c/uL
Standard Error 0.03

PRIMARY outcome

Timeframe: Baseline (Day 1), Day 365

Population: Number of Participants Analyzed=All Treated Population, all participants who entered the open-label period and received at least one dose of abatacept at any time during this period. Treatment groups represent treatment received in the DB period. n=number of participants with data available.

Sodium (Na): \<0.95 x LLN, \>1.05 x ULN; potassium (K): \<0.9 x LLN, \>1.1 x ULN; chloride (Cl): \<0.9 x LLN, \>1.1 x ULN

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=131 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
n=136 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
n=104 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
OL; Mean Change From Baseline to Day 365 in Electrolytes
Na (n=131, n=136, n=104)
-1.62 mEq/L
Standard Error 0.29
-1.57 mEq/L
Standard Error 0.33
-1.09 mEq/L
Standard Error 0.38
OL; Mean Change From Baseline to Day 365 in Electrolytes
K (n=131, n=135, n=104)
-0.03 mEq/L
Standard Error 0.04
-0.07 mEq/L
Standard Error 0.04
-0.03 mEq/L
Standard Error 0.05
OL; Mean Change From Baseline to Day 365 in Electrolytes
Cl (n=131, n=136, n=104)
-1.40 mEq/L
Standard Error 0.28
-1.18 mEq/L
Standard Error 0.31
-1.06 mEq/L
Standard Error 0.33

PRIMARY outcome

Timeframe: Baseline (Day 1), Day 365

Population: Number of Participants Analyzed=All Treated Population, all participants who entered the open-label period and received at least one dose of abatacept at any time during this period. Treatment groups represent treatment received in the DB period. n=number of participants with data available.

Bilirubin: \>2 x ULN; blood urea nitrogen (BUN): \>2 x BL; creatinine: \>4 x BL; calcium (Ca): \<0.8 x LLN, \>1.2 x ULN; phosphorous (P): \<0.75 x LLN, \>1.2 5 x ULN; serum glucose (Glu): \<65 mg/dL, \>220 mg/dL; fasting serum Glu: \<0.8 x LLN, \>1.5 x ULN; uric acid: \>1.5 x ULN;

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=131 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
n=136 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
n=104 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
OL; Mean Change From Baseline to Day 365 in Bilirubin, Blood Urea Nitrogen, Creatinine, Calcium, Phosphorous, Serum Glucose, Fasting Serum Glucose, and Uric Acid
Creatinine (n=131, n=136, n=104)
0.03 mg/dL
Standard Error 0.02
0.02 mg/dL
Standard Error 0.01
0.01 mg/dL
Standard Error 0.02
OL; Mean Change From Baseline to Day 365 in Bilirubin, Blood Urea Nitrogen, Creatinine, Calcium, Phosphorous, Serum Glucose, Fasting Serum Glucose, and Uric Acid
BUN (n=131, n=136, n=104)
-0.31 mg/dL
Standard Error 0.41
-0.52 mg/dL
Standard Error 0.40
0.10 mg/dL
Standard Error 0.53
OL; Mean Change From Baseline to Day 365 in Bilirubin, Blood Urea Nitrogen, Creatinine, Calcium, Phosphorous, Serum Glucose, Fasting Serum Glucose, and Uric Acid
Ca (n=131, n=136, n=104)
0.14 mg/dL
Standard Error 0.04
0.08 mg/dL
Standard Error 0.03
0.14 mg/dL
Standard Error 0.04
OL; Mean Change From Baseline to Day 365 in Bilirubin, Blood Urea Nitrogen, Creatinine, Calcium, Phosphorous, Serum Glucose, Fasting Serum Glucose, and Uric Acid
P (n=131, n=136, n=104)
0.03 mg/dL
Standard Error 0.05
-0.01 mg/dL
Standard Error 0.05
0.05 mg/dL
Standard Error 0.05
OL; Mean Change From Baseline to Day 365 in Bilirubin, Blood Urea Nitrogen, Creatinine, Calcium, Phosphorous, Serum Glucose, Fasting Serum Glucose, and Uric Acid
Uric Acid (n=131, n=136, n=104)
0.09 mg/dL
Standard Error 0.08
0.08 mg/dL
Standard Error 0.10
0.04 mg/dL
Standard Error 0.12
OL; Mean Change From Baseline to Day 365 in Bilirubin, Blood Urea Nitrogen, Creatinine, Calcium, Phosphorous, Serum Glucose, Fasting Serum Glucose, and Uric Acid
Total bilirubin (n=131, n=134, n=104)
0.06 mg/dL
Standard Error 0.01
0.04 mg/dL
Standard Error 0.02
0.03 mg/dL
Standard Error 0.02
OL; Mean Change From Baseline to Day 365 in Bilirubin, Blood Urea Nitrogen, Creatinine, Calcium, Phosphorous, Serum Glucose, Fasting Serum Glucose, and Uric Acid
Serum glucose (n=131, n=136, n=104)
5.66 mg/dL
Standard Error 2.41
2.49 mg/dL
Standard Error 3.15
3.03 mg/dL
Standard Error 2.16

PRIMARY outcome

Timeframe: Baseline (Day 1), Day 365

Population: Number of Participants Analyzed=All Treated Population, all participants who entered the open-label period and received at least one dose of abatacept at any time during this period. Treatment groups represent treatment received in the DB period. n=number of participants with data available.

alanine aminotransferase (ALT): \>3 x ULN; aspartate aminotransferase (AST): \>3 x ULN; G-Glutamyl transferase (GGT): \>2 x ULN; Alkaline phosphatase (ALP): \>2 x ULN

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=131 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
n=136 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
n=104 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
OL; Mean Change From Baseline to Day 365 in Alanine Aminotransferase, Aspartate Aminotransferase, G-Glutamyl Transferase, and Alkaline Phosphatase
ALT (n=131, n=135, n=104)
3.51 U/L
Standard Error 1.33
2.19 U/L
Standard Error 2.31
-0.04 U/L
Standard Error 1.68
OL; Mean Change From Baseline to Day 365 in Alanine Aminotransferase, Aspartate Aminotransferase, G-Glutamyl Transferase, and Alkaline Phosphatase
AST (n=131, n=135, n=104)
0.54 U/L
Standard Error 1.04
-0.11 U/L
Standard Error 1.51
-2.23 U/L
Standard Error 1.41
OL; Mean Change From Baseline to Day 365 in Alanine Aminotransferase, Aspartate Aminotransferase, G-Glutamyl Transferase, and Alkaline Phosphatase
GGT (n=131, n=135, n=104)
2.53 U/L
Standard Error 2.81
-0.61 U/L
Standard Error 1.76
-2.32 U/L
Standard Error 2.73
OL; Mean Change From Baseline to Day 365 in Alanine Aminotransferase, Aspartate Aminotransferase, G-Glutamyl Transferase, and Alkaline Phosphatase
ALP (n=131, n=136, n=104)
-0.53 U/L
Standard Error 2.16
-7.78 U/L
Standard Error 2.24
-4.34 U/L
Standard Error 2.48

PRIMARY outcome

Timeframe: Baseline (Day 1), Day 729

Population: Number of Participants Analyzed=All Treated Population, all participants who entered the open-label period and received at least one dose of abatacept at any time during this period. Treatment groups represent treatment received in the DB period. n=number of participants with data available.

Hemoglobin (HGB): \>3 g/dL decrease from BL; total protein: \< 0.9 x LLN, \>1.1 x ULN; albumin:\<0.9 x LLN

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=124 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
n=127 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
n=102 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
OL; Mean Change From Baseline to Day 729 in Hemoglobin, Total Protein, and Albumin
HGB (n=124, n=125, n=102)
0.66 g/dL
Standard Error 0.10
0.48 g/dL
Standard Error 0.10
0.40 g/dL
Standard Error 0.13
OL; Mean Change From Baseline to Day 729 in Hemoglobin, Total Protein, and Albumin
Total protein (n=124, n=127, n=102)
-0.33 g/dL
Standard Error 0.05
-0.25 g/dL
Standard Error 0.04
-0.29 g/dL
Standard Error 0.05
OL; Mean Change From Baseline to Day 729 in Hemoglobin, Total Protein, and Albumin
Albumin (n=124, n=127, n=102)
0.13 g/dL
Standard Error 0.03
0.10 g/dL
Standard Error 0.03
0.06 g/dL
Standard Error 0.03

PRIMARY outcome

Timeframe: Baseline (Day 1), Day 729

Population: Number of Participants Analyzed=All Treated Population, all participants who entered the open-label period and received at least one dose of abatacept at any time during this period. Treatment groups represent treatment received in the DB period. n=number of participants with data available.

Platelets (PLT): \<0.67 x LLN, \>1.5 x ULN

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=124 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
n=122 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
n=100 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
OL; Mean Change From Baseline to Day 729 in Platelets
-63.9 10^9 c/L
Standard Error 6.04
-5832 10^9 c/L
Standard Error 7.66
-47.7 10^9 c/L
Standard Error 8.16

PRIMARY outcome

Timeframe: Baseline (Day 1), Day 729

Population: Number of Participants Analyzed=All Treated Population, all participants who entered the open-label period and received at least one dose of abatacept at any time during this period. Treatment groups represent treatment received in the DB period. n=number of participants with data available.

Hematocrit: \<0.75 x BL

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=124 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
n=124 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
n=102 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
OL; Mean Change From Baseline to Day 729 in Hematocrit
1.72 percentage of red blood cells
Standard Error 0.29
1.23 percentage of red blood cells
Standard Error 0.29
0.99 percentage of red blood cells
Standard Error 0.38

PRIMARY outcome

Timeframe: Baseline (Day 1), Day 729

Population: Number of Participants Analyzed=All Treated Population, all participants who entered the open-label period and received at least one dose of abatacept at any time during this period. Treatment groups represent treatment received in the DB period. n=number of participants with data available.

Leukocytes: \<0.75 x LLN, \>1.25 x ULN; neutrophils+bands: \<1.0 x 10\^3 c/uL; eosinophils: \>0.750 x 10\^3 c/uL; basophils: \> 400 mm3; monocytes: \>2000 mm3; lymphocytes: \<0.750 x 10\^3 c/uL, \>7.50 x 10\^3 c/uL.

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=124 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
n=125 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
n=102 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
OL; Mean Change From Baseline to Day 729 in White Blood Cells
Leukocytes (n=124, n=125, n=102)
-1.57 10^3 c/uL
Standard Error 0.23
-1.23 10^3 c/uL
Standard Error 0.26
-1.28 10^3 c/uL
Standard Error 0.23
OL; Mean Change From Baseline to Day 729 in White Blood Cells
Neutrophils + bands (n=123, n=123, n=101)
-1.62 10^3 c/uL
Standard Error 0.21
-1.35 10^3 c/uL
Standard Error 0.23
-1.33 10^3 c/uL
Standard Error 0.22
OL; Mean Change From Baseline to Day 729 in White Blood Cells
Basophils (n=123, n=123, n=101)
-0.01 10^3 c/uL
Standard Error 0.00
0.00 10^3 c/uL
Standard Error 0.00
-0.01 10^3 c/uL
Standard Error 0.00
OL; Mean Change From Baseline to Day 729 in White Blood Cells
Monocytes (n=123, n=123, n=101)
-0.05 10^3 c/uL
Standard Error 0.02
-0.02 10^3 c/uL
Standard Error 0.04
-0.03 10^3 c/uL
Standard Error 0.02
OL; Mean Change From Baseline to Day 729 in White Blood Cells
Eosinophils (n=123, n=123, n=101)
-0.01 10^3 c/uL
Standard Error 0.01
-0.03 10^3 c/uL
Standard Error 0.02
-0.05 10^3 c/uL
Standard Error 0.02
OL; Mean Change From Baseline to Day 729 in White Blood Cells
Lymphocytes (n=123, n=123, n=101)
0.13 10^3 c/uL
Standard Error 0.06
0.18 10^3 c/uL
Standard Error 0.06
0.08 10^3 c/uL
Standard Error 0.06

PRIMARY outcome

Timeframe: Baseline (Day 1), Day 729

Population: Number of Participants Analyzed=All Treated Population, all participants who entered the open-label period and received at least one dose of abatacept at any time during this period. Treatment groups represent treatment received in the DB period. n=number of participants with data available.

Erythrocytes: \<0.75 x BL

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=124 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
n=125 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
n=102 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
OL; Mean Change From Baseline to Day 729 in Erythrocytes
0.07 10^6 c/uL
Standard Error 0.03
0.04 10^6 c/uL
Standard Error 0.03
0.02 10^6 c/uL
Standard Error 0.04

PRIMARY outcome

Timeframe: Baseline (Day 1), Day 729

Population: Number of Participants Analyzed=All Treated Population, all participants who entered the open-label period and received at least one dose of abatacept at any time during this period. Treatment groups represent treatment received in the DB period. n=number of participants with data available.

Sodium (Na): \<0.95 x LLN, \>1.05 x ULN; potassium (K): \<0.9 x LLN, \>1.1 x ULN; chloride (Cl): \<0.9 x LLN, \>1.1 x ULN

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=124 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
n=127 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
n=102 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
OL; Mean Change From Baseline to Day 729 in Electrolytes
Na
-1.10 mEq/L
Standard Error 0.28
-1.12 mEq/L
Standard Error 0.29
-1.22 mEq/L
Standard Error 0.38
OL; Mean Change From Baseline to Day 729 in Electrolytes
K
-0.03 mEq/L
Standard Error 0.04
-0.04 mEq/L
Standard Error 0.04
-0.02 mEq/L
Standard Error 0.04
OL; Mean Change From Baseline to Day 729 in Electrolytes
Cl
-1.31 mEq/L
Standard Error 0.26
-1.28 mEq/L
Standard Error 0.31
-2.03 mEq/L
Standard Error 0.29

PRIMARY outcome

Timeframe: Baseline (Day 1), Day 729

Population: Number of Participants Analyzed=All Treated Population, all participants who entered the open-label period and received at least one dose of abatacept at any time during this period. Treatment groups represent treatment received in the DB period. n=number of participants with data available.

Bilirubin: \>2 x ULN; blood urea nitrogen (BUN): \>2 x BL; creatinine: \>4 x BL; calcium (Ca): \<0.8 x LLN, \>1.2 x ULN; phosphorous (P): \<0.75 x LLN, \>1.2 5 x ULN; serum glucose (Glu): \<65 mg/dL, \>220 mg/dL; fasting serum Glu: \<0.8 x LLN, \>1.5 x ULN; uric acid: \>1.5 x ULN;

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=124 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
n=127 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
n=102 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
OL; Mean Change From Baseline to Day 729 in Bilirubin, Blood Urea Nitrogen, Creatinine, Calcium, Phosphorous, Serum Glucose, Fasting Serum Glucose, and Uric Acid
Creatinine (n=124, n=127, n=102)
0.08 mg/dL
Standard Error 0.02
0.08 mg/dL
Standard Error 0.01
0.07 mg/dL
Standard Error 0.02
OL; Mean Change From Baseline to Day 729 in Bilirubin, Blood Urea Nitrogen, Creatinine, Calcium, Phosphorous, Serum Glucose, Fasting Serum Glucose, and Uric Acid
BUN (n=124, n=127, n=102)
-0.37 mg/dL
Standard Error 0.43
-0.12 mg/dL
Standard Error 0.44
0.20 mg/dL
Standard Error 0.46
OL; Mean Change From Baseline to Day 729 in Bilirubin, Blood Urea Nitrogen, Creatinine, Calcium, Phosphorous, Serum Glucose, Fasting Serum Glucose, and Uric Acid
Ca (n=124, n=127, n=102)
0.01 mg/dL
Standard Error 0.04
-0.01 mg/dL
Standard Error 0.05
0.02 mg/dL
Standard Error 0.05
OL; Mean Change From Baseline to Day 729 in Bilirubin, Blood Urea Nitrogen, Creatinine, Calcium, Phosphorous, Serum Glucose, Fasting Serum Glucose, and Uric Acid
P (n=124, n=127, n=102)
-0.05 mg/dL
Standard Error 0.05
-0.16 mg/dL
Standard Error 0.06
-0.08 mg/dL
Standard Error 0.06
OL; Mean Change From Baseline to Day 729 in Bilirubin, Blood Urea Nitrogen, Creatinine, Calcium, Phosphorous, Serum Glucose, Fasting Serum Glucose, and Uric Acid
Uric Acid (n=124, n=127, n=102)
-0.22 mg/dL
Standard Error 0.08
-0.02 mg/dL
Standard Error 0.09
-0.10 mg/dL
Standard Error 0.12
OL; Mean Change From Baseline to Day 729 in Bilirubin, Blood Urea Nitrogen, Creatinine, Calcium, Phosphorous, Serum Glucose, Fasting Serum Glucose, and Uric Acid
Total bilirubin (n=124, n=127, n=101)
0.01 mg/dL
Standard Error 0.02
0.04 mg/dL
Standard Error 0.02
0.03 mg/dL
Standard Error 0.02
OL; Mean Change From Baseline to Day 729 in Bilirubin, Blood Urea Nitrogen, Creatinine, Calcium, Phosphorous, Serum Glucose, Fasting Serum Glucose, and Uric Acid
Serum glucose (n=123, n=126, n=101)
9.92 mg/dL
Standard Error 3.04
7.52 mg/dL
Standard Error 2.02
3.74 mg/dL
Standard Error 2.17

PRIMARY outcome

Timeframe: Baseline (Day 1), Day 729

Population: Number of Participants Analyzed=All Treated Population, all participants who entered the open-label period and received at least one dose of abatacept at any time during this period. Treatment groups represent treatment received in the DB period. n=number of participants with data available.

alanine aminotransferase (ALT): \>3 x ULN; aspartate aminotransferase (AST): \>3 x ULN; G-Glutamyl transferase (GGT): \>2 x ULN; Alkaline phosphatase (ALP): \>2 x ULN

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=124 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
n=127 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
n=102 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
OL; Mean Change From Baseline to Day 729 in Alanine Aminotransferase, Aspartate Aminotransferase, G-Glutamyl Transferase, and Alkaline Phosphatase
ALT
2.73 U/L
Standard Error 1.59
1.02 U/L
Standard Error 1.83
-0.89 U/L
Standard Error 1.96
OL; Mean Change From Baseline to Day 729 in Alanine Aminotransferase, Aspartate Aminotransferase, G-Glutamyl Transferase, and Alkaline Phosphatase
AST
0.03 U/L
Standard Error 1.17
-0.22 U/L
Standard Error 1.22
-2.45 U/L
Standard Error 1.60
OL; Mean Change From Baseline to Day 729 in Alanine Aminotransferase, Aspartate Aminotransferase, G-Glutamyl Transferase, and Alkaline Phosphatase
GGT
1.23 U/L
Standard Error 2.38
-0.41 U/L
Standard Error 2.14
-1.93 U/L
Standard Error 2.95
OL; Mean Change From Baseline to Day 729 in Alanine Aminotransferase, Aspartate Aminotransferase, G-Glutamyl Transferase, and Alkaline Phosphatase
ALP
-0.55 U/L
Standard Error 2.17
-2.61 U/L
Standard Error 2.83
-3.91 U/L
Standard Error 3.41

PRIMARY outcome

Timeframe: Baseline (Day 1), Day 1121

Population: Number of Participants Analyzed=All Treated Population, all participants who entered the open-label period and received at least one dose of abatacept at any time during this period. Treatment groups represent treatment received in the DB period. n=number of participants with data available.

Hemoglobin (HGB): \>3 g/dL decrease from BL; total protein: \< 0.9 x LLN, \>1.1 x ULN; albumin:\<0.9 x LLN

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=102 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
n=98 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
n=86 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
OL; Mean Change From Baseline to Day 1121 in Hemoglobin, Total Protein, and Albumin
HGB (n=102, n=98, n=85)
0.66 g/dL
Standard Error 0.13
0.53 g/dL
Standard Error 0.14
0.57 g/dL
Standard Error 0.13
OL; Mean Change From Baseline to Day 1121 in Hemoglobin, Total Protein, and Albumin
Total protein (n=102, n=98, n=86)
-0.35 g/dL
Standard Error 0.05
-0.24 g/dL
Standard Error 0.05
-0.33 g/dL
Standard Error 0.05
OL; Mean Change From Baseline to Day 1121 in Hemoglobin, Total Protein, and Albumin
Albumin (n=102, n=98, n=86)
0.04 g/dL
Standard Error 0.04
0.08 g/dL
Standard Error 0.04
-0.01 g/dL
Standard Error 0.04

PRIMARY outcome

Timeframe: Baseline (Day 1), Day 1121

Population: Number of Participants Analyzed=All Treated Population, all participants who entered the open-label period and received at least one dose of abatacept at any time during this period. Treatment groups represent treatment received in the DB period. n=number of participants with data available.

Platelets (PLT): \<0.67 x LLN, \>1.5 x ULN

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=101 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
n=95 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
n=85 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
OL; Mean Change From Baseline to Day 1121 in Platelets
-67.5 10^9 c/L
Standard Error 7.49
-66.1 10^9 c/L
Standard Error 8.86
-62.5 10^9 c/L
Standard Error 8.05

PRIMARY outcome

Timeframe: Baseline (Day 1), Day 1121

Population: Number of Participants Analyzed=All Treated Population, all participants who entered the open-label period and received at least one dose of abatacept at any time during this period. Treatment groups represent treatment received in the DB period. n=number of participants with data available.

Hematocrit: \<0.75 x BL

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=100 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
n=98 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
n=85 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
OL; Mean Change From Baseline to Day 1121 in Hematocrit
1.83 percentage of red blood cells
Standard Error 0.37
1.50 percentage of red blood cells
Standard Error 0.39
1.47 percentage of red blood cells
Standard Error 0.39

PRIMARY outcome

Timeframe: Baseline (Day 1), Day 1121

Population: Number of Participants Analyzed=All Treated Population, all participants who entered the open-label period and received at least one dose of abatacept at any time during this period. Treatment groups represent treatment received in the DB period. n=number of participants with data available.

Leukocytes: \<0.75 x LLN, \>1.25 x ULN; neutrophils+bands: \<1.0 x 10\^3 c/uL; eosinophils: \>0.750 x 10\^3 c/uL; basophils: \> 400 mm3; monocytes: \>2000 mm3; lymphocytes: \<0.750 x 10\^3 c/uL, \>7.50 x 10\^3 c/uL.

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=102 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
n=98 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
n=85 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
OL; Mean Change From Baseline to Day 1121 in White Blood Cells
Leukocytes (n=102, n=98, n=85)
-1.07 10^3 c/uL
Standard Error 0.27
-1.09 10^3 c/uL
Standard Error 0.26
-0.99 10^3 c/uL
Standard Error 0.25
OL; Mean Change From Baseline to Day 1121 in White Blood Cells
Neutrophils + bands (n=99, n=96, n=84)
-1.17 10^3 c/uL
Standard Error 0.25
-1.40 10^3 c/uL
Standard Error 0.25
-1.28 10^3 c/uL
Standard Error 0.24
OL; Mean Change From Baseline to Day 1121 in White Blood Cells
Basophils (n=99, n=96, n=85)
0.00 10^3 c/uL
Standard Error 0.00
0.00 10^3 c/uL
Standard Error 0.00
0.00 10^3 c/uL
Standard Error 0.00
OL; Mean Change From Baseline to Day 1121 in White Blood Cells
Monocytes (n=99, n=96, n=84)
0.03 10^3 c/uL
Standard Error 0.02
0.00 10^3 c/uL
Standard Error 0.03
0.01 10^3 c/uL
Standard Error 0.03
OL; Mean Change From Baseline to Day 1121 in White Blood Cells
Eosinophils (n=99, n=96, n=84)
0.00 10^3 c/uL
Standard Error 0.01
-0.06 10^3 c/uL
Standard Error 0.02
-0.04 10^3 c/uL
Standard Error 0.02
OL; Mean Change From Baseline to Day 1121 in White Blood Cells
Lymphocytes (n=99, n=96, n=84)
0.16 10^3 c/uL
Standard Error 0.08
0.34 10^3 c/uL
Standard Error 0.07
0.32 10^3 c/uL
Standard Error 0.10

PRIMARY outcome

Timeframe: Baseline (Day 1), Day 1121

Population: Number of Participants Analyzed=All Treated Population, all participants who entered the open-label period and received at least one dose of abatacept at any time during this period. Treatment groups represent treatment received in the DB period. n=number of participants with data available.

Erythrocytes: \<0.75 x BL

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=102 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
n=98 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
n=85 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
OL; Mean Change From Baseline to Day 1121 in Erythrocytes
0.11 10^6 c/uL
Standard Error 0.03
0.11 10^6 c/uL
Standard Error 0.04
0.12 10^6 c/uL
Standard Error 0.04

PRIMARY outcome

Timeframe: Baseline (Day 1), Day 1121

Population: Number of Participants Analyzed=All Treated Population, all participants who entered the open-label period and received at least one dose of abatacept at any time during this period. Treatment groups represent treatment received in the DB period. n=number of participants with data available.

Sodium (Na): \<0.95 x LLN, \>1.05 x ULN; potassium (K): \<0.9 x LLN, \>1.1 x ULN; chloride (Cl): \<0.9 x LLN, \>1.1 x ULN

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=102 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
n=98 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
n=86 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
OL; Mean Change From Baseline to Day 1121 in Electrolytes
Na (n=102, n=98, n=86)
-1.80 mEq/L
Standard Error 0.33
-1.38 mEq/L
Standard Error 0.38
-1.34 mEq/L
Standard Error 0.42
OL; Mean Change From Baseline to Day 1121 in Electrolytes
K (n=102, n=98, n=85)
0.01 mEq/L
Standard Error 0.04
0.08 mEq/L
Standard Error 0.05
0.01 mEq/L
Standard Error 0.05
OL; Mean Change From Baseline to Day 1121 in Electrolytes
Cl (n=102, n=98, n=86)
-0.88 mEq/L
Standard Error 0.35
-0.94 mEq/L
Standard Error 0.38
-1.42 mEq/L
Standard Error 0.37

PRIMARY outcome

Timeframe: Baseline (Day 1), Day 1121

Population: Number of Participants Analyzed=All Treated Population, all participants who entered the open-label period and received at least one dose of abatacept at any time during this period. Treatment groups represent treatment received in the DB period. n=number of participants with data available.

Bilirubin: \>2 x ULN; blood urea nitrogen (BUN): \>2 x BL; creatinine: \>4 x BL; calcium (Ca): \<0.8 x LLN, \>1.2 x ULN; phosphorous (P): \<0.75 x LLN, \>1.2 5 x ULN; serum glucose (Glu): \<65 mg/dL, \>220 mg/dL; fasting serum Glu: \<0.8 x LLN, \>1.5 x ULN; uric acid: \>1.5 x ULN;

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=102 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
n=98 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
n=86 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
OL; Mean Change From Baseline to Day 1121 in Bilirubin, Blood Urea Nitrogen, Creatinine, Calcium, Phosphorous, Serum Glucose, Fasting Serum Glucose, and Uric Acid
Creatinine (n=102, n=98, n=86)
0.06 mg/dL
Standard Error 0.02
0.07 mg/dL
Standard Error 0.03
0.08 mg/dL
Standard Error 0.02
OL; Mean Change From Baseline to Day 1121 in Bilirubin, Blood Urea Nitrogen, Creatinine, Calcium, Phosphorous, Serum Glucose, Fasting Serum Glucose, and Uric Acid
BUN (n=102, n=98, n=86)
-0.04 mg/dL
Standard Error 0.49
0.34 mg/dL
Standard Error 0.73
0.20 mg/dL
Standard Error 0.56
OL; Mean Change From Baseline to Day 1121 in Bilirubin, Blood Urea Nitrogen, Creatinine, Calcium, Phosphorous, Serum Glucose, Fasting Serum Glucose, and Uric Acid
Ca (n=102, n=98, n=86)
-0.01 mg/dL
Standard Error 0.05
-0.03 mg/dL
Standard Error 0.06
0.04 mg/dL
Standard Error 0.05
OL; Mean Change From Baseline to Day 1121 in Bilirubin, Blood Urea Nitrogen, Creatinine, Calcium, Phosphorous, Serum Glucose, Fasting Serum Glucose, and Uric Acid
P (n=102, n=98, n=85)
-0.18 mg/dL
Standard Error 0.07
-0.19 mg/dL
Standard Error 0.07
-0.11 mg/dL
Standard Error 0.06
OL; Mean Change From Baseline to Day 1121 in Bilirubin, Blood Urea Nitrogen, Creatinine, Calcium, Phosphorous, Serum Glucose, Fasting Serum Glucose, and Uric Acid
Uric Acid (n=102, n=98, n=86)
-0.05 mg/dL
Standard Error 0.11
0.13 mg/dL
Standard Error 0.10
0.20 mg/dL
Standard Error 0.15
OL; Mean Change From Baseline to Day 1121 in Bilirubin, Blood Urea Nitrogen, Creatinine, Calcium, Phosphorous, Serum Glucose, Fasting Serum Glucose, and Uric Acid
Total bilirubin (n=102, n=98, n=86)
0.02 mg/dL
Standard Error 0.02
0.03 mg/dL
Standard Error 0.02
0.03 mg/dL
Standard Error 0.02
OL; Mean Change From Baseline to Day 1121 in Bilirubin, Blood Urea Nitrogen, Creatinine, Calcium, Phosphorous, Serum Glucose, Fasting Serum Glucose, and Uric Acid
Serum glucose (n=101, n=98, n=85)
12.99 mg/dL
Standard Error 3.31
6.91 mg/dL
Standard Error 2.10
9.07 mg/dL
Standard Error 3.20

PRIMARY outcome

Timeframe: Baseline (Day 1), Day 1121

Population: Number of Participants Analyzed=All Treated Population, all participants who entered the open-label period and received at least one dose of abatacept at any time during this period. Treatment groups represent treatment received in the DB period. n=number of participants with data available.

alanine aminotransferase (ALT): \>3 x ULN; aspartate aminotransferase (AST): \>3 x ULN; G-Glutamyl transferase (GGT): \>2 x ULN; Alkaline phosphatase (ALP): \>2 x ULN

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=102 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
n=98 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
n=86 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
OL; Mean Change From Baseline to Day 1121 in Alanine Aminotransferase, Aspartate Aminotransferase, G-Glutamyl Transferase, and Alkaline Phosphatase
ALT (n=102, n=98, n=86)
4.74 U/L
Standard Error 1.95
4.66 U/L
Standard Error 2.88
-0.35 U/L
Standard Error 2.33
OL; Mean Change From Baseline to Day 1121 in Alanine Aminotransferase, Aspartate Aminotransferase, G-Glutamyl Transferase, and Alkaline Phosphatase
AST (n=102, n=98, n=86)
3.79 U/L
Standard Error 1.60
4.49 U/L
Standard Error 2.13
0.38 U/L
Standard Error 1.69
OL; Mean Change From Baseline to Day 1121 in Alanine Aminotransferase, Aspartate Aminotransferase, G-Glutamyl Transferase, and Alkaline Phosphatase
GGT (n=102, n=98, n=86)
1.60 U/L
Standard Error 2.79
-2.88 U/L
Standard Error 2.16
-0.14 U/L
Standard Error 3.79
OL; Mean Change From Baseline to Day 1121 in Alanine Aminotransferase, Aspartate Aminotransferase, G-Glutamyl Transferase, and Alkaline Phosphatase
ALP (n=88, n=79, n=69)
1.25 U/L
Standard Error 2.62
-4.03 U/L
Standard Error 3.79
-7.35 U/L
Standard Error 3.53

PRIMARY outcome

Timeframe: Baseline (Day 1), Day 1513

Population: Number of Participants Analyzed=All Treated Population, all participants who entered the open-label period and received at least one dose of abatacept at any time during this period. Treatment groups represent treatment received in the DB period. n=number of participants with data available.

Hemoglobin (HGB): \>3 g/dL decrease from BL; total protein: \< 0.9 x LLN, \>1.1 x ULN; albumin:\<0.9 x LLN

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=23 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
n=20 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
n=16 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
OL; Mean Change From Baseline to Day 1513 in Hemoglobin, Total Protein, and Albumin
HGB
0.25 g/dL
Standard Error 0.33
0.44 g/dL
Standard Error 0.31
0.56 g/dL
Standard Error 0.32
OL; Mean Change From Baseline to Day 1513 in Hemoglobin, Total Protein, and Albumin
Total protein
-0.73 g/dL
Standard Error 0.09
-0.33 g/dL
Standard Error 0.11
-0.34 g/dL
Standard Error 0.14
OL; Mean Change From Baseline to Day 1513 in Hemoglobin, Total Protein, and Albumin
Albumin
-0.06 g/dL
Standard Error 0.07
0.10 g/dL
Standard Error 0.07
0.00 g/dL
Standard Error 0.11

PRIMARY outcome

Timeframe: Baseline (Day 1), Day 1513

Population: Number of Participants Analyzed=All Treated Population, all participants who entered the open-label period and received at least one dose of abatacept at any time during this period. Treatment groups represent treatment received in the DB period. n=number of participants with data available.

Platelets (PLT): \<0.67 x LLN, \>1.5 x ULN

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=23 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
n=19 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
n=16 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
OL; Mean Change From Baseline to Day 1513 in Platelets
-78.0 10^9 c/L
Standard Error 17.20
-74.0 10^9 c/L
Standard Error 16.18
-99.2 10^9 c/L
Standard Error 19.83

PRIMARY outcome

Timeframe: Baseline (Day 1), Day 1513

Population: Number of Participants Analyzed=All Treated Population, all participants who entered the open-label period and received at least one dose of abatacept at any time during this period. Treatment groups represent treatment received in the DB period. n=number of participants with data available.

Hematocrit: \<0.75 x BL

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=23 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
n=19 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
n=16 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
OL; Mean Change From Baseline to Day 1513 in Hematocrit
0.92 percentage of red blood cells
Standard Error 1.00
1.28 percentage of red blood cells
Standard Error 0.92
1.18 percentage of red blood cells
Standard Error 1.00

PRIMARY outcome

Timeframe: Baseline (Day 1), Day 1513

Population: Number of Participants Analyzed=All Treated Population, all participants who entered the open-label period and received at least one dose of abatacept at any time during this period. Treatment groups represent treatment received in the DB period. n=number of participants with data available.

Leukocytes: \<0.75 x LLN, \>1.25 x ULN; neutrophils+bands: \<1.0 x 10\^3 c/uL; eosinophils: \>0.750 x 10\^3 c/uL; basophils: \> 400 mm3; monocytes: \>2000 mm3; lymphocytes: \<0.750 x 10\^3 c/uL, \>7.50 x 10\^3 c/uL.

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=23 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
n=20 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
n=16 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
OL; Mean Change From Baseline to Day 1513 in White Blood Cells
Leukocytes (n=23, n=20, n=16)
-0.34 10^3 c/uL
Standard Error 0.45
-1.08 10^3 c/uL
Standard Error 0.63
-2.13 10^3 c/uL
Standard Error 0.50
OL; Mean Change From Baseline to Day 1513 in White Blood Cells
Neutrophils + bands (n=22, n=17, n=16)
-0.37 10^3 c/uL
Standard Error 0.33
-1.03 10^3 c/uL
Standard Error 0.68
-1.93 10^3 c/uL
Standard Error 0.50
OL; Mean Change From Baseline to Day 1513 in White Blood Cells
Basophils (n=22, n=17, n=16)
0.00 10^3 c/uL
Standard Error 0.01
-0.01 10^3 c/uL
Standard Error 0.01
-0.01 10^3 c/uL
Standard Error 0.01
OL; Mean Change From Baseline to Day 1513 in White Blood Cells
Monocytes (n=22, n=17, n=16)
0.01 10^3 c/uL
Standard Error 0.03
-0.10 10^3 c/uL
Standard Error 0.09
-0.05 10^3 c/uL
Standard Error 0.04
OL; Mean Change From Baseline to Day 1513 in White Blood Cells
Eosinophils (n=22, n=17, n=16)
0.04 10^3 c/uL
Standard Error 0.06
-0.11 10^3 c/uL
Standard Error 0.16
-0.23 10^3 c/uL
Standard Error 0.00
OL; Mean Change From Baseline to Day 1513 in White Blood Cells
Lymphocytes (n=22, n=17, n=16)
0.20 10^3 c/uL
Standard Error 0.14
0.16 10^3 c/uL
Standard Error 0.16
-0.15 10^3 c/uL
Standard Error 0.16

PRIMARY outcome

Timeframe: Baseline (Day 1), Day 1513

Population: Number of Participants Analyzed=All Treated Population, all participants who entered the open-label period and received at least one dose of abatacept at any time during this period. Treatment groups represent treatment received in the DB period. n=number of participants with data available.

Erythrocytes: \<0.75 x BL

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=23 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
n=19 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
n=16 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
OL; Mean Change From Baseline to Day 1513 in Erythrocytes
-0.10 10^6 c/uL
Standard Error 0.09
0.00 10^6 c/uL
Standard Error 0.09
-0.09 10^6 c/uL
Standard Error 0.08

PRIMARY outcome

Timeframe: Baseline (Day 1), Day 1513

Population: Number of Participants Analyzed=All Treated Population, all participants who entered the open-label period and received at least one dose of abatacept at any time during this period. Treatment groups represent treatment received in the DB period. n=number of participants with data available.

Sodium (Na): \<0.95 x LLN, \>1.05 x ULN; potassium (K): \<0.9 x LLN, \>1.1 x ULN; chloride (Cl): \<0.9 x LLN, \>1.1 x ULN

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=23 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
n=20 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
n=16 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
OL; Mean Change From Baseline to Day 1513 in Electrolytes
Na (n=22, n=20, n=16)
-4.36 mEq/L
Standard Error 0.73
-3.80 mEq/L
Standard Error 0.99
-4.50 mEq/L
Standard Error 0.74
OL; Mean Change From Baseline to Day 1513 in Electrolytes
K (n=23, n=20, n=16)
-0.16 mEq/L
Standard Error 0.10
-0.32 mEq/L
Standard Error 0.08
-0.46 mEq/L
Standard Error 0.11
OL; Mean Change From Baseline to Day 1513 in Electrolytes
Cl (n=23, n=20, n=16)
-2.48 mEq/L
Standard Error 0.71
-2.60 mEq/L
Standard Error 0.84
-4.13 mEq/L
Standard Error 0.88

PRIMARY outcome

Timeframe: Baseline (Day 1), Day 1513

Population: Number of Participants Analyzed=All Treated Population, all participants who entered the open-label period and received at least one dose of abatacept at any time during this period. Treatment groups represent treatment received in the DB period. n=number of participants with data available.

Bilirubin: \>2 x ULN; blood urea nitrogen (BUN): \>2 x BL; creatinine: \>4 x BL; calcium (Ca): \<0.8 x LLN, \>1.2 x ULN; phosphorous (P): \<0.75 x LLN, \>1.2 5 x ULN; serum glucose (Glu): \<65 mg/dL, \>220 mg/dL; fasting serum Glu: \<0.8 x LLN, \>1.5 x ULN; uric acid: \>1.5 x ULN;

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=23 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
n=20 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
n=16 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
OL; Mean Change From Baseline to Day 1513 in Bilirubin, Blood Urea Nitrogen, Creatinine, Calcium, Phosphorous, Serum Glucose, Fasting Serum Glucose, and Uric Acid
Serum glucose
8.87 mg/dL
Standard Error 3.19
9.00 mg/dL
Standard Error 1.88
8.44 mg/dL
Standard Error 4.38
OL; Mean Change From Baseline to Day 1513 in Bilirubin, Blood Urea Nitrogen, Creatinine, Calcium, Phosphorous, Serum Glucose, Fasting Serum Glucose, and Uric Acid
Creatinine
0.10 mg/dL
Standard Error 0.02
0.05 mg/dL
Standard Error 0.04
0.08 mg/dL
Standard Error 0.06
OL; Mean Change From Baseline to Day 1513 in Bilirubin, Blood Urea Nitrogen, Creatinine, Calcium, Phosphorous, Serum Glucose, Fasting Serum Glucose, and Uric Acid
BUN
2.87 mg/dL
Standard Error 0.90
-0.40 mg/dL
Standard Error 1.13
0.63 mg/dL
Standard Error 1.36
OL; Mean Change From Baseline to Day 1513 in Bilirubin, Blood Urea Nitrogen, Creatinine, Calcium, Phosphorous, Serum Glucose, Fasting Serum Glucose, and Uric Acid
Ca
0.27 mg/dL
Standard Error 0.07
0.38 mg/dL
Standard Error 0.09
0.35 mg/dL
Standard Error 0.12
OL; Mean Change From Baseline to Day 1513 in Bilirubin, Blood Urea Nitrogen, Creatinine, Calcium, Phosphorous, Serum Glucose, Fasting Serum Glucose, and Uric Acid
P
-0.09 mg/dL
Standard Error 0.11
-0.51 mg/dL
Standard Error 0.16
-0.17 mg/dL
Standard Error 0.13
OL; Mean Change From Baseline to Day 1513 in Bilirubin, Blood Urea Nitrogen, Creatinine, Calcium, Phosphorous, Serum Glucose, Fasting Serum Glucose, and Uric Acid
Uric Acid
0.03 mg/dL
Standard Error 0.18
0.06 mg/dL
Standard Error 0.21
0.33 mg/dL
Standard Error 0.33
OL; Mean Change From Baseline to Day 1513 in Bilirubin, Blood Urea Nitrogen, Creatinine, Calcium, Phosphorous, Serum Glucose, Fasting Serum Glucose, and Uric Acid
Total bilirubin
0.08 mg/dL
Standard Error 0.10
0.09 mg/dL
Standard Error 0.03
0.23 mg/dL
Standard Error 0.14

PRIMARY outcome

Timeframe: Baseline (Day 1), Day 1513

Population: Number of Participants Analyzed=All Treated Population, all participants who entered the open-label period and received at least one dose of abatacept at any time during this period. Treatment groups represent treatment received in the DB period. n=number of participants with data available.

alanine aminotransferase (ALT): \>3 x ULN; aspartate aminotransferase (AST): \>3 x ULN; G-Glutamyl transferase (GGT): \>2 x ULN; Alkaline phosphatase (ALP): \>2 x ULN

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=23 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
n=20 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
n=16 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
OL; Mean Change From Baseline to Day 1513 in Alanine Aminotransferase, Aspartate Aminotransferase, G-Glutamyl Transferase, and Alkaline Phosphatase
ALT
-1.87 U/L
Standard Error 2.73
-9.20 U/L
Standard Error 3.75
2.44 U/L
Standard Error 8.07
OL; Mean Change From Baseline to Day 1513 in Alanine Aminotransferase, Aspartate Aminotransferase, G-Glutamyl Transferase, and Alkaline Phosphatase
AST
-1.35 U/L
Standard Error 1.72
-2.85 U/L
Standard Error 2.55
0.38 U/L
Standard Error 7.23
OL; Mean Change From Baseline to Day 1513 in Alanine Aminotransferase, Aspartate Aminotransferase, G-Glutamyl Transferase, and Alkaline Phosphatase
GGT
-3.00 U/L
Standard Error 2.99
-10.9 U/L
Standard Error 5.79
-3.06 U/L
Standard Error 10.30
OL; Mean Change From Baseline to Day 1513 in Alanine Aminotransferase, Aspartate Aminotransferase, G-Glutamyl Transferase, and Alkaline Phosphatase
ALP
-15.8 U/L
Standard Error 5.23
-18.7 U/L
Standard Error 7.12
-11.30 U/L
Standard Error 7.80

PRIMARY outcome

Timeframe: Days 365, 729, 1121, and 1513

Population: Number of Participants Analyzed=All Treated Population, all participants who entered the open-label period and received at least one dose of abatacept at any time during this period.n=number of participants with data available.

Seated Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP), units=mm mercury (Hg)

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=372 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
OL; Mean Systolic (SBP) and Diastolic (DBP) Blood Pressure During Open Label Period
Day 365 SBP pre-dose (n=343)
119.0 mm mercury (Hg)
Standard Deviation 15.03
OL; Mean Systolic (SBP) and Diastolic (DBP) Blood Pressure During Open Label Period
Day 365 SBP post-dose (n=341)
118.8 mm mercury (Hg)
Standard Deviation 15.35
OL; Mean Systolic (SBP) and Diastolic (DBP) Blood Pressure During Open Label Period
Day 729 SBP pre-dose (n=321)
120.4 mm mercury (Hg)
Standard Deviation 15.20
OL; Mean Systolic (SBP) and Diastolic (DBP) Blood Pressure During Open Label Period
Day 729 SBP post-dose (n=323)
119.5 mm mercury (Hg)
Standard Deviation 15.02
OL; Mean Systolic (SBP) and Diastolic (DBP) Blood Pressure During Open Label Period
Day 1121 SBP pre-dose (n=265)
121.1 mm mercury (Hg)
Standard Deviation 15.59
OL; Mean Systolic (SBP) and Diastolic (DBP) Blood Pressure During Open Label Period
Day 1121 SBP post-dose (n=265)
119.2 mm mercury (Hg)
Standard Deviation 13.99
OL; Mean Systolic (SBP) and Diastolic (DBP) Blood Pressure During Open Label Period
Day 1513 SBP pre-dose (n=52)
114.6 mm mercury (Hg)
Standard Deviation 13.57
OL; Mean Systolic (SBP) and Diastolic (DBP) Blood Pressure During Open Label Period
Day 1513 SBP post-dose (n=52)
114.2 mm mercury (Hg)
Standard Deviation 12.90
OL; Mean Systolic (SBP) and Diastolic (DBP) Blood Pressure During Open Label Period
Day 365 DBP pre-dose (n=343)
74.5 mm mercury (Hg)
Standard Deviation 9.80
OL; Mean Systolic (SBP) and Diastolic (DBP) Blood Pressure During Open Label Period
Day 365 DBP post-dose (n=341)
74.0 mm mercury (Hg)
Standard Deviation 10.18
OL; Mean Systolic (SBP) and Diastolic (DBP) Blood Pressure During Open Label Period
Day 729 DBP pre-dose (n=321)
74.9 mm mercury (Hg)
Standard Deviation 9.69
OL; Mean Systolic (SBP) and Diastolic (DBP) Blood Pressure During Open Label Period
Day 729 DBP post-dose (n=323)
74.6 mm mercury (Hg)
Standard Deviation 9.92
OL; Mean Systolic (SBP) and Diastolic (DBP) Blood Pressure During Open Label Period
Day 1121 DBP pre-dose (n=265)
74.9 mm mercury (Hg)
Standard Deviation 9.45
OL; Mean Systolic (SBP) and Diastolic (DBP) Blood Pressure During Open Label Period
Day 1121 DBP post-dose (n=265)
73.6 mm mercury (Hg)
Standard Deviation 9.12
OL; Mean Systolic (SBP) and Diastolic (DBP) Blood Pressure During Open Label Period
Day 1513 DBP pre-dose (n=52)
71.7 mm mercury (Hg)
Standard Deviation 9.45
OL; Mean Systolic (SBP) and Diastolic (DBP) Blood Pressure During Open Label Period
Day 1513 DBP post-dose (n=52)
72.1 mm mercury (Hg)
Standard Deviation 9.11

PRIMARY outcome

Timeframe: Days 365, 729, 1121, and 1513

Population: Number of Participants Analyzed=All Treated Population, all participants who entered the open-label period and received at least one dose of abatacept at any time during this period.n=number of participants with data available.

Heart Rate (HR), units=beats per minute (bpm)

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=372 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
OL; Mean Heart Rate (HR) During Open Label Period
Day 365 HR pre-dose (n=343)
74.2 beats per minute (bpm)
Standard Deviation 9.30
OL; Mean Heart Rate (HR) During Open Label Period
Day 365 HR post-dose (n=341)
74.1 beats per minute (bpm)
Standard Deviation 8.57
OL; Mean Heart Rate (HR) During Open Label Period
Day 729 HR pre-dose (n=322)
74.2 beats per minute (bpm)
Standard Deviation 9.12
OL; Mean Heart Rate (HR) During Open Label Period
Day 729 HR post-dose (n=324)
73.4 beats per minute (bpm)
Standard Deviation 8.59
OL; Mean Heart Rate (HR) During Open Label Period
Day 1121 HR pre-dose (n=265)
73.9 beats per minute (bpm)
Standard Deviation 9.31
OL; Mean Heart Rate (HR) During Open Label Period
Day 1121 HR post-dose (n=265)
73.8 beats per minute (bpm)
Standard Deviation 9.46
OL; Mean Heart Rate (HR) During Open Label Period
Day 1513 HR pre-dose (n=52)
73.0 beats per minute (bpm)
Standard Deviation 8.38
OL; Mean Heart Rate (HR) During Open Label Period
Day 1513 HR post-dose (n=52)
73.8 beats per minute (bpm)
Standard Deviation 7.16

PRIMARY outcome

Timeframe: Days 365, 729, 1121, and 1513

Population: Number of Participants Analyzed=All Treated Population, all participants who entered the open-label period and received at least one dose of abatacept at any time during this period.n=number of participants with data available.

Temperature (T), units=degrees Celcius

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=372 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
OL; Mean Temperature (T) During Open Label Period
Day 365 T pre-dose (n=339)
36.3 degrees Celsius
Standard Deviation 0.43
OL; Mean Temperature (T) During Open Label Period
Day 365 T post-dose (n=339)
36.3 degrees Celsius
Standard Deviation 0.41
OL; Mean Temperature (T) During Open Label Period
Day 729 T pre-dose (n=320)
36.3 degrees Celsius
Standard Deviation 0.45
OL; Mean Temperature (T) During Open Label Period
Day 729 T post-dose (n=323)
36.3 degrees Celsius
Standard Deviation 0.42
OL; Mean Temperature (T) During Open Label Period
Day 1121 T pre-dose (n=263)
36.2 degrees Celsius
Standard Deviation 0.51
OL; Mean Temperature (T) During Open Label Period
Day 1121 T post-dose (n=264)
36.2 degrees Celsius
Standard Deviation 0.47
OL; Mean Temperature (T) During Open Label Period
Day 1513 T pre-dose (n=52)
36.1 degrees Celsius
Standard Deviation 0.35
OL; Mean Temperature (T) During Open Label Period
Day 1513 T post-dose (n=52)
36.1 degrees Celsius
Standard Deviation 0.37

SECONDARY outcome

Timeframe: Baseline (Day 1), 6 months (Day 197)

Population: The Intent-to-Treat (ITT) analysis population was defined to include all participants randomized into the study who received study medication. Participants were grouped according to the treatment or treatment regimen to which they were randomized. All participants who were randomized but never received study medication were excluded.

The DAS28 is a continuous disease measure which is a composite of 4 variables: the 28 tender joint count, the 28 swollen joint count, ESR or CRP, and participant assessment of disease activity measure on a visual analogue scale. The DAS28 has numeric thresholds that define high disease activity (\> 5.1), low disease activity (\< 3.2) and remission (\< 2.6). A clinically significant response is a decrease in DAS28 score of \>1.2 from baseline.

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=156 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
n=102 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
DB; Adjusted Mean Change From Baseline to Day 197 in DAS 28 Score (ESR) For INF Versus PLA (LOCF Analysis)
-2.25 units on a scale
Standard Error 0.12
-1.48 units on a scale
Standard Error 0.15

SECONDARY outcome

Timeframe: From Day 1 through Day 365 (12 months)

Population: The Intent-to-Treat (ITT) analysis population was defined to include all participants randomized into the study who received study medication. Participants were grouped according to the treatment or treatment regimen to which they were randomized. All participants who were randomized but never received study medication were excluded.

The DAS28 is a continuous disease measure which is a composite of 4 variables: the 28 tender joint count, the 28 swollen joint count, ESR or CRP, and participant assessment of disease activity measure on a visual analogue scale. The DAS28 has numeric thresholds that define high disease activity (\> 5.1), low disease activity (\< 3.2) and remission (\< 2.6). Clinically significant response= decrease in DAS28 score of \>1.2 from baseline. DAS28 AUC can be calculated from the DAS28 score versus time curve, which provides an assessment of changes in disease activity over time.

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=150 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
n=156 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
DB; DAS 28 (ESR) Area Under The Curve (AUC) Over 12 Months For ABA Versus INF
1638.6 units on a scale
Standard Deviation 395.81
1657.5 units on a scale
Standard Deviation 460.52

SECONDARY outcome

Timeframe: DB Day 197

Population: The Intent-to-Treat (ITT) analysis population was defined to include all participants randomized into the study who received study medication. Participants were grouped according to the treatment or treatment regimen to which they were randomized. All participants who were randomized but never received study medication were excluded.

The disability section of the full HAQ includes 20 questions to assess physical functions in 8 domains: dressing, arising, eating, walking, hygiene, reach, grip and common activities. The questions are evaluated on a 4-point scale: 0=without any difficulty, 1= with some difficulty, 2= with much difficulty, and 3= unable to do. Higher scores= greater dysfunction. A disability index was calculated by summing the worst scores in each domain and dividing by the number of domains answered. Clinically meaningful HAQ response=an improvement of at least 0.3 units from baseline in HAQ disability Index.

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=156 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
n=165 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
n=110 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
DB; Percentage of Participants With Clinically Meaningful Health Assessment Questionnaire-Disability Index (HAQ-DI) Response at Day 197
61.5 percentage of participants
58.8 percentage of participants
40.9 percentage of participants

SECONDARY outcome

Timeframe: DB Day 365

Population: The Intent-to-Treat (ITT) analysis population was defined to include all participants randomized into the study who received study medication. Participants were grouped according to the treatment or treatment regimen to which they were randomized. All participants who were randomized but never received study medication were excluded.

The disability section of the full HAQ includes 20 questions to assess physical functions in 8 domains: dressing, arising, eating, walking, hygiene, reach, grip and common activities. The questions are evaluated on a 4-point scale: 0=without any difficulty, 1= with some difficulty, 2= with much difficulty, and 3= unable to do. Higher scores= greater dysfunction. A disability index was calculated by summing the worst scores in each domain and dividing by the number of domains answered. Clinically meaningful HAQ response=an improvement of at least 0.3 units from baseline in HAQ disability Index.

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=156 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
n=165 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
n=110 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
DB; Percentage of Participants With Clinically Meaningful Health Assessment Questionnaire-Disability Index (HAQ-DI) Response at Day 365
57.7 percentage of participants
52.7 percentage of participants
57.3 percentage of participants

SECONDARY outcome

Timeframe: Baseline (Day 1), 6 months (Day 197)

Population: The Intent-to-Treat (ITT) analysis population was defined to include all participants randomized into the study who received study medication. Participants were grouped according to the treatment or treatment regimen to which they were randomized. All participants who were randomized but never received study medication were excluded.

The disability section of the full HAQ includes 20 questions to assess physical functions in 8 domains: dressing, arising, eating, walking, hygiene, reach, grip and common activities. The questions are evaluated on a 4-point scale: 0=without any difficulty, 1= with some difficulty, 2= with much difficulty, and 3= unable to do. Higher scores= greater dysfunction. A disability index was calculated by summing the worst scores in each domain and dividing by the number of domains answered. Clinically meaningful HAQ response=an improvement of at least 0.3 units from baseline in HAQ disability Index.

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=156 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
n=164 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
n=109 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
DB; Adjusted Mean Change From Baseline to Day 197 in HAQ-DI (LOCF Analysis)
HAQ-DI component: activities
-0.61 units on a scale
Standard Error 0.06
-0.54 units on a scale
Standard Error 0.06
-0.22 units on a scale
Standard Error 0.08
DB; Adjusted Mean Change From Baseline to Day 197 in HAQ-DI (LOCF Analysis)
HAQ-DI component: dressing and grooming
-0.69 units on a scale
Standard Error 0.06
-0.57 units on a scale
Standard Error 0.06
-0.37 units on a scale
Standard Error 0.07
DB; Adjusted Mean Change From Baseline to Day 197 in HAQ-DI (LOCF Analysis)
HAQ-DI component: eating
-0.79 units on a scale
Standard Error 0.06
-0.77 units on a scale
Standard Error 0.06
-0.36 units on a scale
Standard Error 0.08
DB; Adjusted Mean Change From Baseline to Day 197 in HAQ-DI (LOCF Analysis)
HAQ-DI component: grip
-0.73 units on a scale
Standard Error 0.07
-0.70 units on a scale
Standard Error 0.07
-0.26 units on a scale
Standard Error 0.08
DB; Adjusted Mean Change From Baseline to Day 197 in HAQ-DI (LOCF Analysis)
HAQ-DI component: hygiene
-0.64 units on a scale
Standard Error 0.07
-0.48 units on a scale
Standard Error 0.07
-0.26 units on a scale
Standard Error 0.08
DB; Adjusted Mean Change From Baseline to Day 197 in HAQ-DI (LOCF Analysis)
HAQ-DI component: reach
-0.72 units on a scale
Standard Error 0.07
-0.64 units on a scale
Standard Error 0.07
-0.30 units on a scale
Standard Error 0.08
DB; Adjusted Mean Change From Baseline to Day 197 in HAQ-DI (LOCF Analysis)
HAQ-DI component: arising
-0.70 units on a scale
Standard Error 0.06
-0.68 units on a scale
Standard Error 0.06
-0.39 units on a scale
Standard Error 0.07
DB; Adjusted Mean Change From Baseline to Day 197 in HAQ-DI (LOCF Analysis)
HAQ-DI component: walking
-0.58 units on a scale
Standard Error 0.06
-0.56 units on a scale
Standard Error 0.06
-0.23 units on a scale
Standard Error 0.07
DB; Adjusted Mean Change From Baseline to Day 197 in HAQ-DI (LOCF Analysis)
HAQ-DI
-0.69 units on a scale
Standard Error 0.05
-0.61 units on a scale
Standard Error 0.05
-0.31 units on a scale
Standard Error 0.06

SECONDARY outcome

Timeframe: Baseline (Day 1), 12 months (Day 365)

Population: Intent-to-Treat (ITT) Population: all participants randomized into the study receiving study medication, grouped according to randomization treatment. All participants randomized but never receiving study medication excluded. Although 3 participants in PLA group discontinued before Day 197, 2 of these patients were included in the LOCF analysis.

The disability section of the full HAQ includes 20 questions to assess physical functions in 8 domains: dressing, arising, eating, walking, hygiene, reach, grip and common activities. The questions are evaluated on a 4-point scale: 0=without any difficulty, 1= with some difficulty, 2= with much difficulty, and 3= unable to do. Higher scores= greater dysfunction. A disability index was calculated by summing the worst scores in each domain and dividing by the number of domains answered. Clinically meaningful HAQ response=an improvement of at least 0.3 units from baseline in HAQ disability Index.

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=156 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
n=164 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
n=109 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
DB; Adjusted Mean Change From Baseline to Day 365 in HAQ-DI (LOCF Analysis)
HAQ-DI
-0.67 units on a scale
Standard Error 0.05
-0.59 units on a scale
Standard Error 0.05
-0.56 units on a scale
Standard Error 0.06
DB; Adjusted Mean Change From Baseline to Day 365 in HAQ-DI (LOCF Analysis)
HAQ-DI component: activities
-0.55 units on a scale
Standard Error 0.07
-0.52 units on a scale
Standard Error 0.07
-0.55 units on a scale
Standard Error 0.08
DB; Adjusted Mean Change From Baseline to Day 365 in HAQ-DI (LOCF Analysis)
HAQ-DI component: dressing and grooming
-0.72 units on a scale
Standard Error 0.06
-0.60 units on a scale
Standard Error 0.06
-0.56 units on a scale
Standard Error 0.07
DB; Adjusted Mean Change From Baseline to Day 365 in HAQ-DI (LOCF Analysis)
HAQ-DI component: eating
-0.80 units on a scale
Standard Error 0.06
-0.73 units on a scale
Standard Error 0.06
-0.71 units on a scale
Standard Error 0.08
DB; Adjusted Mean Change From Baseline to Day 365 in HAQ-DI (LOCF Analysis)
HAQ-DI component: grip
-0.77 units on a scale
Standard Error 0.07
-0.64 units on a scale
Standard Error 0.07
-0.56 units on a scale
Standard Error 0.08
DB; Adjusted Mean Change From Baseline to Day 365 in HAQ-DI (LOCF Analysis)
HAQ-DI component: hygiene
-0.53 units on a scale
Standard Error 0.07
-0.45 units on a scale
Standard Error 0.07
-0.42 units on a scale
Standard Error 0.09
DB; Adjusted Mean Change From Baseline to Day 365 in HAQ-DI (LOCF Analysis)
HAQ-DI component: reach
-0.77 units on a scale
Standard Error 0.07
-0.66 units on a scale
Standard Error 0.07
-0.53 units on a scale
Standard Error 0.08
DB; Adjusted Mean Change From Baseline to Day 365 in HAQ-DI (LOCF Analysis)
HAQ-DI component: arising
-0.68 units on a scale
Standard Error 0.06
-0.64 units on a scale
Standard Error 0.06
-0.61 units on a scale
Standard Error 0.07
DB; Adjusted Mean Change From Baseline to Day 365 in HAQ-DI (LOCF Analysis)
HAQ-DI component: walking
-0.54 units on a scale
Standard Error 0.06
-0.55 units on a scale
Standard Error 0.06
-0.47 units on a scale
Standard Error 0.07

SECONDARY outcome

Timeframe: Baseline (Day 1), 6 months (Day 197)

Population: ITT population, all participants randomized into the study receiving study medication. Participants grouped according to the treatment to which they were randomized. All randomized participants who never received study medication were excluded. SF-36 component scores were not presented in tabular form.

The SF-36 is a validated instrument measuring health-related quality of life across multiple disease states. It has 36 questions with 8 subscale scores and 2 summary scores (1) physical component summary=physical functioning, role-physical, bodily pain, and general health; (2) mental component summary=vitality, social functioning, role-emotional, and mental health. There is no total overall score; scoring is done for both subscores and summary scores. For subscores and summary scores, 0 =worst score (or quality of life) and 100=best score. Change from Baseline= post-Baseline - Baseline value.

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=154 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
n=163 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
n=109 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
DB; Adjusted Mean Change From Baseline to Day 197 in SF-36 Physical Component Summary (PCS) and Mental Component Summary (MCS)
SF-36 Physical Component Summary
8.36 units on a scale
Standard Error 0.69
7.66 units on a scale
Standard Error 0.67
4.34 units on a scale
Standard Error 0.82
DB; Adjusted Mean Change From Baseline to Day 197 in SF-36 Physical Component Summary (PCS) and Mental Component Summary (MCS)
SF-36 Mental Component Summary
5.14 units on a scale
Standard Error 0.79
4.32 units on a scale
Standard Error 0.76
1.64 units on a scale
Standard Error 0.93

SECONDARY outcome

Timeframe: Baseline (Day 1), 12 months (Day 365)

Population: ITT Population: all participants randomized into the study receiving study medication, grouped according to randomization treatment. Although 3 participants in PLA group discontinued before Day 197, 2 of these patients were included in the LOCF analysis. SF-36 component scores were not presented in tabular form.

The SF-36 is a validated instrument measuring health-related quality of life across multiple disease states. It has 36 questions with 8 subscale scores and 2 summary scores (1) physical component summary=physical functioning, role-physical, bodily pain, and general health; (2) mental component summary=vitality, social functioning, role-emotional, and mental health. There is no total overall score; scoring is done for both subscores and summary scores. For subscores and summary scores, 0 =worst score (or quality of life) and 100=best score. Change from Baseline= post-Baseline - Baseline value.

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=154 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
n=163 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
n=109 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
DB; Adjusted Mean Change From Baseline to Day 365 in SF-36 Physical Component Summary (PCS) and Mental Component Summary (MCS)
SF-36 Physical Component Summary
9.52 units on a scale
Standard Error 0.70
7.59 units on a scale
Standard Error 0.68
8.00 units on a scale
Standard Error 0.83
DB; Adjusted Mean Change From Baseline to Day 365 in SF-36 Physical Component Summary (PCS) and Mental Component Summary (MCS)
SF-36 Mental Component Summary
5.96 units on a scale
Standard Error 0.81
4.03 units on a scale
Standard Error 0.79
5.85 units on a scale
Standard Error 0.97

SECONDARY outcome

Timeframe: DB Day 365

Population: The Intent-to-Treat (ITT) analysis population was defined to include all participants randomized into the study who received study medication. Participants were grouped according to the treatment or treatment regimen to which they were randomized. All participants who were randomized but never received study medication were excluded.

The DAS28 is a continuous disease measure composite of 4 variables: 28 tender joint count, 28 swollen joint count, ESR or CRP, and participant assessment of disease activity measure on a visual analogue scale. High disease activity= \> 5.1, low disease activity= \< 3.2, and remission= \< 2.6. Clinically significant response= decrease of \>1.2 from baseline. Utilizing EULAR response criteria, DAS28 categorical responses define a good (absolute: \<3.2 or \>1.2 improvement from baseline \[BL\]), moderate (absolute: 3.2-5.1 or 0.6-1.2 change from BL), or no response (absolute: \>5.1 or \<0.6 change from BL)

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=150 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
n=157 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
n=102 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
DB; Percentage of Participants With Good, Moderate, or No Response According to European League Against Rheumatism (EULAR) at Day 365
No response
27.3 percentage of participants
36.3 percentage of participants
23.5 percentage of participants
DB; Percentage of Participants With Good, Moderate, or No Response According to European League Against Rheumatism (EULAR) at Day 365
Moderate response
40.7 percentage of participants
45.2 percentage of participants
49.0 percentage of participants
DB; Percentage of Participants With Good, Moderate, or No Response According to European League Against Rheumatism (EULAR) at Day 365
Good response
32.0 percentage of participants
18.5 percentage of participants
27.5 percentage of participants

SECONDARY outcome

Timeframe: DB Day 197

Population: The Intent-to-Treat (ITT) analysis population was defined to include all participants randomized into the study who received study medication. Participants were grouped according to the treatment or treatment regimen to which they were randomized. All participants who were randomized but never received study medication were excluded.

The ACR 20 definition of improvement is a 20% improvement from baseline in the number of tender and swollen joint counts, and a 20% improvement from baseline in 3 of the remaining 5 core set measures: participant global assessment of pain, participant global assessment of disease activity, physician global assessment of disease activity, participant assessment of physical function and acute phase reactant value (C-reactive protein \[CRP\]). The evaluation for 50% improvement (ACR 50) and 70% improvement (ACR 70) follow similarly.

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=156 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
n=165 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
n=110 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
DB; Percentage of Participants With American College of Rheumatology (ACR) Responses at Day 197
Day 197, ACR 20
66.7 percentage of participants
59.4 percentage of participants
41.8 percentage of participants
DB; Percentage of Participants With American College of Rheumatology (ACR) Responses at Day 197
Day 197, ACR 50
40.4 percentage of participants
37.0 percentage of participants
20.0 percentage of participants
DB; Percentage of Participants With American College of Rheumatology (ACR) Responses at Day 197
Day 197, ACR 70
20.5 percentage of participants
24.2 percentage of participants
9.1 percentage of participants

SECONDARY outcome

Timeframe: DB Day 365

Population: The Intent-to-Treat (ITT) analysis population was defined to include all participants randomized into the study who received study medication. Participants were grouped according to the treatment or treatment regimen to which they were randomized. All participants who were randomized but never received study medication were excluded.

The ACR 20 definition of improvement is a 20% improvement from baseline in the number of tender and swollen joint counts, and a 20% improvement from baseline in 3 of the remaining 5 core set measures: participant global assessment of pain, participant global assessment of disease activity, physician global assessment of disease activity, participant assessment of physical function and acute phase reactant value (C-reactive protein \[CRP\]). The evaluation for 50% improvement (ACR 50) and 70% improvement (ACR 70) follow similarly.

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=156 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
n=165 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
n=110 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
DB; Percentage of Participants With American College of Rheumatology (ACR) Responses at Day 365
Day 365, ACR 20
72.4 percentage of participants
55.8 percentage of participants
68.2 percentage of participants
DB; Percentage of Participants With American College of Rheumatology (ACR) Responses at Day 365
Day 365, ACR 50
45.5 percentage of participants
36.4 percentage of participants
50.9 percentage of participants
DB; Percentage of Participants With American College of Rheumatology (ACR) Responses at Day 365
Day 365, ACR 70
26.3 percentage of participants
20.6 percentage of participants
29.1 percentage of participants

SECONDARY outcome

Timeframe: From Baseline (Day 1) through Day 197, and up to 56 days after last dose if occurring on-study

Population: The As-Treated analysis population contained all participants who received at least one dose of double-blind study medication, and participants were grouped on an as-assigned or randomized basis unless the participant received the incorrect medication for the entire period of treatment.

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.

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=156 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
n=165 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
n=110 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
DB; Number of Participants With Death, Serious Adverse Events (SAEs), Related SAEs, SAEs Leading to Discontinuation, AEs, Related AEs, and AEs Leading to Discontinuation From Day 1 Through Day 197
Deaths
1 participants
1 participants
0 participants
DB; Number of Participants With Death, Serious Adverse Events (SAEs), Related SAEs, SAEs Leading to Discontinuation, AEs, Related AEs, and AEs Leading to Discontinuation From Day 1 Through Day 197
SAEs
8 participants
19 participants
13 participants
DB; Number of Participants With Death, Serious Adverse Events (SAEs), Related SAEs, SAEs Leading to Discontinuation, AEs, Related AEs, and AEs Leading to Discontinuation From Day 1 Through Day 197
Related SAEs
3 participants
8 participants
3 participants
DB; Number of Participants With Death, Serious Adverse Events (SAEs), Related SAEs, SAEs Leading to Discontinuation, AEs, Related AEs, and AEs Leading to Discontinuation From Day 1 Through Day 197
SAEs Leading to Discontinuation
2 participants
4 participants
0 participants
DB; Number of Participants With Death, Serious Adverse Events (SAEs), Related SAEs, SAEs Leading to Discontinuation, AEs, Related AEs, and AEs Leading to Discontinuation From Day 1 Through Day 197
AEs
129 participants
140 participants
92 participants
DB; Number of Participants With Death, Serious Adverse Events (SAEs), Related SAEs, SAEs Leading to Discontinuation, AEs, Related AEs, and AEs Leading to Discontinuation From Day 1 Through Day 197
Related AEs
64 participants
74 participants
46 participants
DB; Number of Participants With Death, Serious Adverse Events (SAEs), Related SAEs, SAEs Leading to Discontinuation, AEs, Related AEs, and AEs Leading to Discontinuation From Day 1 Through Day 197
AEs Leading to discontinuation
3 participants
8 participants
1 participants

SECONDARY outcome

Timeframe: From Baseline (Day 1) through Day 197, and up to 56 days after last dose if occurring on-study

Population: The As-Treated analysis population contained all participants who received at least one dose of double-blind study medication, and participants were grouped on an as-assigned or randomized basis unless the participant received the incorrect medication for the entire period of treatment.

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, autoimmune disorders; malignancies; and acute infusional AEs (pre-specified AEs occurring within 1 hour of start of infusion).

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=156 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
n=165 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
n=110 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
DB; Number of Participants With AEs of Special Interest From Day 1 Through Day 197
Pre-specified infections
12 participants
18 participants
8 participants
DB; Number of Participants With AEs of Special Interest From Day 1 Through Day 197
Neoplasms: Benign, malignant, and unspecified
1 participants
2 participants
1 participants
DB; Number of Participants With AEs of Special Interest From Day 1 Through Day 197
Prespecified autoimmune symptoms and disorders
1 participants
1 participants
1 participants
DB; Number of Participants With AEs of Special Interest From Day 1 Through Day 197
Pre-specified infusional AEs
8 participants
30 participants
11 participants

SECONDARY outcome

Timeframe: From Baseline (Day 1) through Day 365, and up to 56 days after last dose if occurring on-study

Population: The As-Treated analysis population contained all participants who received at least one dose of double-blind study medication, and participants were grouped on an as-assigned or randomized basis unless the participant received the incorrect medication for the entire period of treatment.

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.

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=156 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
n=165 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
DB; Number of Participants With Death, Serious Adverse Events (SAEs), Related SAEs, SAEs Leading to Discontinuation, AEs, Related AEs, and AEs Leading to Discontinuation From Day 1 Through Day 365
Deaths
1 participants
2 participants
DB; Number of Participants With Death, Serious Adverse Events (SAEs), Related SAEs, SAEs Leading to Discontinuation, AEs, Related AEs, and AEs Leading to Discontinuation From Day 1 Through Day 365
SAEs
15 participants
30 participants
DB; Number of Participants With Death, Serious Adverse Events (SAEs), Related SAEs, SAEs Leading to Discontinuation, AEs, Related AEs, and AEs Leading to Discontinuation From Day 1 Through Day 365
Related SAEs
5 participants
14 participants
DB; Number of Participants With Death, Serious Adverse Events (SAEs), Related SAEs, SAEs Leading to Discontinuation, AEs, Related AEs, and AEs Leading to Discontinuation From Day 1 Through Day 365
SAEs Leading to Discontinuation
4 participants
6 participants
DB; Number of Participants With Death, Serious Adverse Events (SAEs), Related SAEs, SAEs Leading to Discontinuation, AEs, Related AEs, and AEs Leading to Discontinuation From Day 1 Through Day 365
AEs
139 participants
154 participants
DB; Number of Participants With Death, Serious Adverse Events (SAEs), Related SAEs, SAEs Leading to Discontinuation, AEs, Related AEs, and AEs Leading to Discontinuation From Day 1 Through Day 365
Related AEs
72 participants
96 participants
DB; Number of Participants With Death, Serious Adverse Events (SAEs), Related SAEs, SAEs Leading to Discontinuation, AEs, Related AEs, and AEs Leading to Discontinuation From Day 1 Through Day 365
AEs Leading to discontinuation
5 participants
12 participants

SECONDARY outcome

Timeframe: From Day 198 through Day 365, and up to 56 days after last dose if occurring on-study

Population: The As-Treated analysis population contained all participants who received at least one dose of double-blind study medication, and participants were grouped on an as-assigned or randomized basis unless the participant received the incorrect medication for the entire period of treatment.

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.

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=110 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
DB; Number of Participants With Death, Serious Adverse Events (SAEs), Related SAEs, SAEs Leading to Discontinuation, AEs, Related AEs, and AEs Leading to Discontinuation From Day 198 Through Day 365 in Participants Receiving Placebo Switched to Abatacept
Deaths
1 participants
DB; Number of Participants With Death, Serious Adverse Events (SAEs), Related SAEs, SAEs Leading to Discontinuation, AEs, Related AEs, and AEs Leading to Discontinuation From Day 198 Through Day 365 in Participants Receiving Placebo Switched to Abatacept
SAEs
12 participants
DB; Number of Participants With Death, Serious Adverse Events (SAEs), Related SAEs, SAEs Leading to Discontinuation, AEs, Related AEs, and AEs Leading to Discontinuation From Day 198 Through Day 365 in Participants Receiving Placebo Switched to Abatacept
Related SAEs
3 participants
DB; Number of Participants With Death, Serious Adverse Events (SAEs), Related SAEs, SAEs Leading to Discontinuation, AEs, Related AEs, and AEs Leading to Discontinuation From Day 198 Through Day 365 in Participants Receiving Placebo Switched to Abatacept
SAEs Leading to Discontinuation
0 participants
DB; Number of Participants With Death, Serious Adverse Events (SAEs), Related SAEs, SAEs Leading to Discontinuation, AEs, Related AEs, and AEs Leading to Discontinuation From Day 198 Through Day 365 in Participants Receiving Placebo Switched to Abatacept
AEs
71 participants
DB; Number of Participants With Death, Serious Adverse Events (SAEs), Related SAEs, SAEs Leading to Discontinuation, AEs, Related AEs, and AEs Leading to Discontinuation From Day 198 Through Day 365 in Participants Receiving Placebo Switched to Abatacept
Related AEs
26 participants
DB; Number of Participants With Death, Serious Adverse Events (SAEs), Related SAEs, SAEs Leading to Discontinuation, AEs, Related AEs, and AEs Leading to Discontinuation From Day 198 Through Day 365 in Participants Receiving Placebo Switched to Abatacept
AEs Leading to discontinuation
0 participants

SECONDARY outcome

Timeframe: From Baseline (Day 1) through Day 365, and up to 56 days after last dose if occurring on-study

Population: The As-Treated analysis population contained all participants who received at least one dose of double-blind study medication, and participants were grouped on an as-assigned or randomized basis unless the participant received the incorrect medication for the entire period of treatment.

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, autoimmune disorders; malignancies; and acute infusional AEs (pre-specified AEs occurring within 1 hour of start of infusion).

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=156 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
n=165 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
DB; Number of Participants With AEs of Special Interest From Day 1 Through Day 365
Pre-specified infections
16 participants
30 participants
DB; Number of Participants With AEs of Special Interest From Day 1 Through Day 365
Neoplasms:Benign, malignant, and unspecified
1 participants
2 participants
DB; Number of Participants With AEs of Special Interest From Day 1 Through Day 365
Prespecified autoimmune symptoms and disorders
2 participants
1 participants
DB; Number of Participants With AEs of Special Interest From Day 1 Through Day 365
Pre-specified infusional AEs
11 participants
41 participants

SECONDARY outcome

Timeframe: From Day 198 through Day 365, and up to 56 days after last dose if occurring on-study

Population: The As-Treated analysis population contained all participants who received at least one dose of double-blind study medication, and participants were grouped on an as-assigned or randomized basis unless the participant received the incorrect medication for the entire period of treatment.

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, autoimmune disorders; malignancies; and acute infusional AEs (pre-specified AEs occurring within 1 hour of start of infusion).

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=110 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
DB; Number of Participants With AEs of Special Interest From Day 198 Through Day 365 in Participants Receiving Placebo Switched to Abatacept
Pre-specified infections
3 participants
DB; Number of Participants With AEs of Special Interest From Day 198 Through Day 365 in Participants Receiving Placebo Switched to Abatacept
Prespecified autoimmune symptoms and disorders
1 participants
DB; Number of Participants With AEs of Special Interest From Day 198 Through Day 365 in Participants Receiving Placebo Switched to Abatacept
Pre-specified infusional AEs
5 participants

SECONDARY outcome

Timeframe: From Baseline (Day 1) through Day 197, or Day 1 through Day 365, and up to 56 days after last dose if occurring on-study

Population: As-Treated Population

Seated Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP) were assessed as clinically significant or relevant at the discretion of the Clinical Investigator. Criteria may have varied between institutions.

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=156 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
n=165 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
n=110 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
DB; Number of Participants With Significant Changes in Mean Systolic and Diastolic Blood Pressure During Days 1 Through 197 and Days 1 Through 365
Days 1-197
0 participants
0 participants
0 participants
DB; Number of Participants With Significant Changes in Mean Systolic and Diastolic Blood Pressure During Days 1 Through 197 and Days 1 Through 365
Days 1-365
0 participants
0 participants
0 participants

SECONDARY outcome

Timeframe: From Baseline (Day 1) through Day 197, or Day 1 through Day 365, and up to 56 days after last dose if occurring on-study

Population: As Treated Population.

Heart Rate (HR) was assessed as clinically significant or relevant at the discretion of the Clinical Investigator. Criteria may have varied between institutions.

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=156 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
n=165 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
n=110 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
DB; Number of Participants With Significant Changes in Mean Heart Rate During Days 1 Through 197 and Days 1 Through 365
Days 1-197
0 participants
0 participants
0 participants
DB; Number of Participants With Significant Changes in Mean Heart Rate During Days 1 Through 197 and Days 1 Through 365
Days 1-365
0 participants
0 participants
0 participants

SECONDARY outcome

Timeframe: From Baseline (Day 1) through Day 197, and up to 56 days after last dose if occurring on-study

Population: As Treated Population.

Temperature (T) was assessed as clinically significant or relevant at the discretion of the Clinical Investigator. Criteria may have varied between institutions.

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=156 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
n=165 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
n=110 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
DB; Number of Participants With Significant Changes in Mean Temperature During Days 1 Through 197 and Days 1 Through 365
Days 1-197
0 participants
0 participants
0 participants
DB; Number of Participants With Significant Changes in Mean Temperature During Days 1 Through 197 and Days 1 Through 365
Days 1-365
0 participants
0 participants
0 participants

SECONDARY outcome

Timeframe: From Baseline (Day 1) through Day 197, and up to 56 days after last dose if occurring on-study

Population: The As-Treated analysis population contained all participants who received at least one dose of double-blind study medication, and participants were grouped on an as-assigned or randomized basis unless the participant received the incorrect medication for the entire period of treatment.

High=greater than Upper Normal Limit (ULN), Low=lower than Lower Normal Limit (LLN). LLN/ULN= Hemoglobin (HGB): \>3 g/dL decrease from Baseline (BL); Hematocrit: \<0.75 x BL; Platelets (PLT): \<0.67 x LLN/\>1.5 x ULN; Leukocytes: \<0.75 x LLN/ \>1.25 x ULN; neutrophils+bands: \<1.0 x 10\^3 c/uL; aspartate aminotransferase (AST): \>3 x ULN; alanine aminotransferase (ALT): \>3 x ULN; creatinine: \>4 x BL

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=155 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
n=162 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
n=108 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
DB; Number of Participants With Select Hematologic and Blood Chemistry Laboratory Abnormalities on Days 1 Through 197
Low HGB (n=155, n=162, n=108)
1 participants
1 participants
1 participants
DB; Number of Participants With Select Hematologic and Blood Chemistry Laboratory Abnormalities on Days 1 Through 197
Low hematocrit (n=155, n=162, n=108)
0 participants
2 participants
0 participants
DB; Number of Participants With Select Hematologic and Blood Chemistry Laboratory Abnormalities on Days 1 Through 197
Low PLT (n=154, n=160, n=108)
1 participants
2 participants
0 participants
DB; Number of Participants With Select Hematologic and Blood Chemistry Laboratory Abnormalities on Days 1 Through 197
High PLT (n=154, n=160, n=108)
0 participants
0 participants
1 participants
DB; Number of Participants With Select Hematologic and Blood Chemistry Laboratory Abnormalities on Days 1 Through 197
Low leukocytes (n=155, n=162, n=108)
0 participants
1 participants
0 participants
DB; Number of Participants With Select Hematologic and Blood Chemistry Laboratory Abnormalities on Days 1 Through 197
High leukocytes (n=155, n=162, n=108)
6 participants
12 participants
16 participants
DB; Number of Participants With Select Hematologic and Blood Chemistry Laboratory Abnormalities on Days 1 Through 197
Low neutrophils + bands (n=155, n=162, n=108)
0 participants
0 participants
1 participants
DB; Number of Participants With Select Hematologic and Blood Chemistry Laboratory Abnormalities on Days 1 Through 197
High AST (n=155, n=162, n=108)
3 participants
3 participants
1 participants
DB; Number of Participants With Select Hematologic and Blood Chemistry Laboratory Abnormalities on Days 1 Through 197
High ALT (n=155, n=162, n=108)
3 participants
2 participants
3 participants
DB; Number of Participants With Select Hematologic and Blood Chemistry Laboratory Abnormalities on Days 1 Through 197
High creatinine (n=155, n=162, n=108)
6 participants
9 participants
5 participants

SECONDARY outcome

Timeframe: From Baseline (Day 1) through Day 365, and up to 56 days after last dose if occurring on-study

Population: The As-Treated analysis population contained all participants who received at least one dose of double-blind study medication, and participants were grouped on an as-assigned or randomized basis unless the participant received the incorrect medication for the entire period of treatment.

High=greater than Upper Normal Limit (ULN), Low=lower than Lower Normal Limit (LLN). LLN/ULN= Hemoglobin (HGB): \>3 g/dL decrease from Baseline (BL); Hematocrit: \<0.75 x BL; Platelets (PLT): \<0.67 x LLN/\>1.5 x ULN; Leukocytes: \<0.75 x LLN/ \>1.25 x ULN; neutrophils+bands: \<1.0 x 10\^3 c/uL; aspartate aminotransferase (AST): \>3 x ULN; alanine aminotransferase (ALT): \>3 x ULN; creatinine: \>4 x BL

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=156 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
n=164 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
n=109 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
DB; Number of Participants With Select Hematologic and Blood Chemistry Laboratory Abnormalities on Days 1 Through 365
Low HGB (n=156, n=164, n=109)
2 participants
1 participants
1 participants
DB; Number of Participants With Select Hematologic and Blood Chemistry Laboratory Abnormalities on Days 1 Through 365
Low hematocrit (n=156, n=164, n=109)
1 participants
2 participants
0 participants
DB; Number of Participants With Select Hematologic and Blood Chemistry Laboratory Abnormalities on Days 1 Through 365
Low PLT (n=155, n=162, n=109)
1 participants
2 participants
0 participants
DB; Number of Participants With Select Hematologic and Blood Chemistry Laboratory Abnormalities on Days 1 Through 365
High PLT (n=155, n=162, n=109)
0 participants
0 participants
1 participants
DB; Number of Participants With Select Hematologic and Blood Chemistry Laboratory Abnormalities on Days 1 Through 365
Low leukocytes (n=156, n=164, n=109)
0 participants
1 participants
0 participants
DB; Number of Participants With Select Hematologic and Blood Chemistry Laboratory Abnormalities on Days 1 Through 365
High leukocytes (n=156, n=164, n=109)
7 participants
22 participants
20 participants
DB; Number of Participants With Select Hematologic and Blood Chemistry Laboratory Abnormalities on Days 1 Through 365
Low neutrophils + bands (n=156, n=164, n=109)
0 participants
0 participants
1 participants
DB; Number of Participants With Select Hematologic and Blood Chemistry Laboratory Abnormalities on Days 1 Through 365
High AST (n=156, n=164, n=109)
4 participants
6 participants
3 participants
DB; Number of Participants With Select Hematologic and Blood Chemistry Laboratory Abnormalities on Days 1 Through 365
High ALT (n=156, n=164, n=109)
3 participants
7 participants
5 participants
DB; Number of Participants With Select Hematologic and Blood Chemistry Laboratory Abnormalities on Days 1 Through 365
High creatinine (n=156, n=164, n=109)
10 participants
13 participants
7 participants

SECONDARY outcome

Timeframe: Day 1 through day 365

Population: The immunogenicity analysis population included participants who received at least one dose of abatacept and had immunogenicity samples collected at baseline and at least one post-baseline treatment visit.

ECL screened sera for drug-specific antibodies, immunocompetition was used to identify specific anti-Abatacept reactivity. Cytotoxic leukocyte antigen 4 (CTLA4) and Possibly Immunoglobulin (Ig) Category=reactivity against extracellular domain of human CTLA4, constant regions of human IgG1, or both (CTLA4Ig; Abatacept molecule). Ig and/or Junction Category=reactivity against constant regions and/or hinge region of human IgG1. Drug-induced seropositivity was defined as a post-baseline titer higher than Baseline, or any post-baseline positivity if Baseline value was missing.

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=156 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
n=110 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
DB; Number of Participants With Anti-Abatacept Antibodies From Day 1 Through Day 365 (Electrochemiluminescent [ECL] Immunoassay)
CTLA4 and Possibly Ig
0 participants
0 participants
DB; Number of Participants With Anti-Abatacept Antibodies From Day 1 Through Day 365 (Electrochemiluminescent [ECL] Immunoassay)
Ig and/or Junction
0 participants
0 participants

SECONDARY outcome

Timeframe: Day 1 through day 365

Population: The immunogenicity analysis population included participants who received at least one dose of infliximab and had immunogenicity samples collected at baseline and at least one post-baseline treatment visit.

Infliximab levels were measured using a microplate enzyme-linked immunosorbant assay (ELISA) with infliximab bound to immobilized recombinant tumor necrosis factor (TNF)-alpha. Bound infliximab is detected utilizing a horseradish peroxidase-conjugated anti-human IgG Fc(fragment, crystallizable region)-specific). The enzyme turns over the substrate O-phenlenediamine to a chromogenic product that is measured at 490 nm. The cut-off value was 1.40 ug/mL; this was based on the mean (+ 3 SD) value in serum samples from 40 participants who had never received infliximab.

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=163 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
DB; Percentage of Participants With Antibodies Against Infliximab (Human Anti-chimeric Antibody [HACA]) From Day 1 Through Day 365
Post Day 28 indeterminate anti-HACA
27.5 percentage of participants
DB; Percentage of Participants With Antibodies Against Infliximab (Human Anti-chimeric Antibody [HACA]) From Day 1 Through Day 365
Discontinued, overall anti-HACA
60.9 percentage of participants
DB; Percentage of Participants With Antibodies Against Infliximab (Human Anti-chimeric Antibody [HACA]) From Day 1 Through Day 365
Discontinued, overall indeterminate anti-HACA
47.8 percentage of participants
DB; Percentage of Participants With Antibodies Against Infliximab (Human Anti-chimeric Antibody [HACA]) From Day 1 Through Day 365
Discontinued, post day 28 anti-HACA
55.0 percentage of participants
DB; Percentage of Participants With Antibodies Against Infliximab (Human Anti-chimeric Antibody [HACA]) From Day 1 Through Day 365
Discontinued, post day 28 indeterminate anti-HACA
25.0 percentage of participants
DB; Percentage of Participants With Antibodies Against Infliximab (Human Anti-chimeric Antibody [HACA]) From Day 1 Through Day 365
Discontinued, post day 56 anti-HACA
72.7 percentage of participants
DB; Percentage of Participants With Antibodies Against Infliximab (Human Anti-chimeric Antibody [HACA]) From Day 1 Through Day 365
Discontinued, post day 56 indeterminate anti-HACA
9.1 percentage of participants
DB; Percentage of Participants With Antibodies Against Infliximab (Human Anti-chimeric Antibody [HACA]) From Day 1 Through Day 365
Discontinued, post day 85 anti-HACA
88.9 percentage of participants
DB; Percentage of Participants With Antibodies Against Infliximab (Human Anti-chimeric Antibody [HACA]) From Day 1 Through Day 365
Discontinued, post day 85 indeterminate anti-HACA
0 percentage of participants
DB; Percentage of Participants With Antibodies Against Infliximab (Human Anti-chimeric Antibody [HACA]) From Day 1 Through Day 365
Missed doses, overall anti-HACA
73.1 percentage of participants
DB; Percentage of Participants With Antibodies Against Infliximab (Human Anti-chimeric Antibody [HACA]) From Day 1 Through Day 365
Missed doses, overall indeterminate anti-HACA
76.9 percentage of participants
DB; Percentage of Participants With Antibodies Against Infliximab (Human Anti-chimeric Antibody [HACA]) From Day 1 Through Day 365
Missed 1 dose, anti-HACA
72.0 percentage of participants
DB; Percentage of Participants With Antibodies Against Infliximab (Human Anti-chimeric Antibody [HACA]) From Day 1 Through Day 365
Missed 1 dose, indeterminate anti-HACA
76.0 percentage of participants
DB; Percentage of Participants With Antibodies Against Infliximab (Human Anti-chimeric Antibody [HACA]) From Day 1 Through Day 365
Missed >1 dose, anti-HACA
100.0 percentage of participants
DB; Percentage of Participants With Antibodies Against Infliximab (Human Anti-chimeric Antibody [HACA]) From Day 1 Through Day 365
Missed >1 dose, indeterminate anti-HACA
100.0 percentage of participants
DB; Percentage of Participants With Antibodies Against Infliximab (Human Anti-chimeric Antibody [HACA]) From Day 1 Through Day 365
Day 309 indeterminate anti-HACA
29.7 percentage of participants
DB; Percentage of Participants With Antibodies Against Infliximab (Human Anti-chimeric Antibody [HACA]) From Day 1 Through Day 365
Post Day 28 anti-HACA
52.2 percentage of participants
DB; Percentage of Participants With Antibodies Against Infliximab (Human Anti-chimeric Antibody [HACA]) From Day 1 Through Day 365
Overall anti-HACA
62.0 percentage of participants
DB; Percentage of Participants With Antibodies Against Infliximab (Human Anti-chimeric Antibody [HACA]) From Day 1 Through Day 365
Overall indeterminate anti-HACA
73.0 percentage of participants
DB; Percentage of Participants With Antibodies Against Infliximab (Human Anti-chimeric Antibody [HACA]) From Day 1 Through Day 365
Day 1 anti-HACA
0 percentage of participants
DB; Percentage of Participants With Antibodies Against Infliximab (Human Anti-chimeric Antibody [HACA]) From Day 1 Through Day 365
Day 1 indeterminate anti-HACA
3.7 percentage of participants
DB; Percentage of Participants With Antibodies Against Infliximab (Human Anti-chimeric Antibody [HACA]) From Day 1 Through Day 365
Day 113 anti-HACA
20.0 percentage of participants
DB; Percentage of Participants With Antibodies Against Infliximab (Human Anti-chimeric Antibody [HACA]) From Day 1 Through Day 365
Day 113 indeterminate anti-HACA
74.7 percentage of participants
DB; Percentage of Participants With Antibodies Against Infliximab (Human Anti-chimeric Antibody [HACA]) From Day 1 Through Day 365
Day 197 anti-HACA
42.2 percentage of participants
DB; Percentage of Participants With Antibodies Against Infliximab (Human Anti-chimeric Antibody [HACA]) From Day 1 Through Day 365
Day 197 indeterminate anti-HACA
33.3 percentage of participants
DB; Percentage of Participants With Antibodies Against Infliximab (Human Anti-chimeric Antibody [HACA]) From Day 1 Through Day 365
Day 309 anti-HACA
53.6 percentage of participants

SECONDARY outcome

Timeframe: Baseline (Day 1), Day 365, Day 533, Day 729

Population: Number of Participants Analyzed=All Treated Population, all participants who entered the open-label period and received at least one dose of abatacept at any time during this period. Treatment groups represent treatment received in the DB period.n=number of participants with data available.

The DAS28 is a continuous disease measure which is a composite of 4 variables: the 28 tender joint count, the 28 swollen joint count, ESR or CRP, and participant assessment of disease activity measure on a visual analogue scale. The DAS28 has numeric thresholds that define high disease activity (\> 5.1), low disease activity (\< 3.2) and remission (\< 2.6). A clinically significant response is a decrease in DAS28 score of \>1.2 from baseline.

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=132 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
n=136 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
n=104 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
OL; Mean Change From Baseline Over Time in DAS 28 (ESR) Score
Day 365 (n=122, n=130, n=94)
-3.12 units on a scale
Standard Error 0.13
-2.39 units on a scale
Standard Error 0.13
-2.81 units on a scale
Standard Error 0.16
OL; Mean Change From Baseline Over Time in DAS 28 (ESR) Score
Day 533 (n=118, n=121, n=92)
-3.21 units on a scale
Standard Error 0.13
-3.04 units on a scale
Standard Error 0.13
-2.84 units on a scale
Standard Error 0.17
OL; Mean Change From Baseline Over Time in DAS 28 (ESR) Score
Day 729 (n=110, n=121, n=93)
-3.35 units on a scale
Standard Error 0.14
-3.29 units on a scale
Standard Error 0.12
-2.98 units on a scale
Standard Error 0.17

SECONDARY outcome

Timeframe: Baseline (Day 1), Day 365, Day 533, Day 729

Population: Number of Participants Analyzed=All Treated Population, all participants who entered the open-label period and received at least one dose of abatacept at any time during this period. Efficacy data was summarized for the 3 DB treatment cohorts.n=number of participants with data available.

The DAS28 is a continuous disease measure which is a composite of 4 variables: the 28 tender joint count, the 28 swollen joint count, ESR or CRP, and participant assessment of disease activity measure on a visual analogue scale. The DAS28 has numeric thresholds that define high disease activity (\> 5.1), low disease activity (\< 3.2) and remission (\< 2.6). A clinically significant response is a decrease in DAS28 score of \>1.2 from baseline.

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=132 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
n=136 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
n=104 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
OL; Percentage of Participants With DAS28 (ESR) Remission and Low Disease Activity (LDAS) Over Time
Day 365 Remission (n=127, n=135, n=102)
19.7 percentage of participants
13.3 percentage of participants
15.7 percentage of participants
OL; Percentage of Participants With DAS28 (ESR) Remission and Low Disease Activity (LDAS) Over Time
Day 365 LDAS (n=127, n=135, n=102)
37.0 percentage of participants
23.0 percentage of participants
29.4 percentage of participants
OL; Percentage of Participants With DAS28 (ESR) Remission and Low Disease Activity (LDAS) Over Time
Day 533 Remission (n=122, n=125, n=98)
20.5 percentage of participants
20.0 percentage of participants
19.4 percentage of participants
OL; Percentage of Participants With DAS28 (ESR) Remission and Low Disease Activity (LDAS) Over Time
Day 533 LDAS (n=122, n=125, n=98)
37.7 percentage of participants
33.6 percentage of participants
35.7 percentage of participants
OL; Percentage of Participants With DAS28 (ESR) Remission and Low Disease Activity (LDAS) Over Time
Day 729 Remission (n=115, n=126, n=100)
26.1 percentage of participants
28.6 percentage of participants
22.0 percentage of participants
OL; Percentage of Participants With DAS28 (ESR) Remission and Low Disease Activity (LDAS) Over Time
Day 729 LDAS (n=115, n=126, n=100)
41.7 percentage of participants
45.2 percentage of participants
34.0 percentage of participants

SECONDARY outcome

Timeframe: DB Days 365, 533, and 729

Population: Number of Participants Analyzed=All Treated Population, all participants who entered the open-label period and received at least one dose of abatacept at any time during this period. Treatment groups represent treatment received in the DB period.n=number of participants with data available.

The DAS28 is a continuous disease measure composite of 4 variables: 28 tender joint count, 28 swollen joint count, ESR or CRP, and participant assessment of disease activity measure on a visual analogue scale. High disease activity= \> 5.1, low disease activity= \< 3.2, and remission= \< 2.6. Clinically significant response= decrease of \>1.2 from baseline. Utilizing EULAR response criteria, DAS28 categorical responses define a good (absolute \<3.2 or \>1.2 improvement from baseline \[BL\]), moderate (absolute 3.2-5.1 or 0.6-1.2 change from BL), or no response (absolute \>5.1 or \<0.6 change from BL)

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=132 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
n=136 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
n=104 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
OL; Percentage of Participants With Good, Moderate, or No Response According to European League Against Rheumatism (EULAR) Over Time
Day 365 Good response (n=122, n=130, n=94)
38.5 percentage of participants
23.1 percentage of participants
30.9 percentage of participants
OL; Percentage of Participants With Good, Moderate, or No Response According to European League Against Rheumatism (EULAR) Over Time
Day 365 Moderate response (n=122, n=130, n=94)
53.3 percentage of participants
58.5 percentage of participants
55.3 percentage of participants
OL; Percentage of Participants With Good, Moderate, or No Response According to European League Against Rheumatism (EULAR) Over Time
Day 365 No response (n=122, n=130, n=94)
8.2 percentage of participants
18.5 percentage of participants
13.8 percentage of participants
OL; Percentage of Participants With Good, Moderate, or No Response According to European League Against Rheumatism (EULAR) Over Time
Day 533 No response (n=118, n=121, n=92)
3.4 percentage of participants
8.3 percentage of participants
10.9 percentage of participants
OL; Percentage of Participants With Good, Moderate, or No Response According to European League Against Rheumatism (EULAR) Over Time
Day 533 Moderate response (n=118, n=121, n=92)
58.5 percentage of participants
58.7 percentage of participants
53.3 percentage of participants
OL; Percentage of Participants With Good, Moderate, or No Response According to European League Against Rheumatism (EULAR) Over Time
Day 729 Good response (n=110, n=121, n=93)
41.8 percentage of participants
45.5 percentage of participants
34.4 percentage of participants
OL; Percentage of Participants With Good, Moderate, or No Response According to European League Against Rheumatism (EULAR) Over Time
Day 729 Moderate response (n=110, n=121, n=93)
53.6 percentage of participants
47.9 percentage of participants
51.6 percentage of participants
OL; Percentage of Participants With Good, Moderate, or No Response According to European League Against Rheumatism (EULAR) Over Time
Day 729 No response (n=110, n=121, n=93)
4.5 percentage of participants
6.6 percentage of participants
14.0 percentage of participants
OL; Percentage of Participants With Good, Moderate, or No Response According to European League Against Rheumatism (EULAR) Over Time
Day 533 Good response (n=118, n=121, n=92)
38.1 percentage of participants
33.1 percentage of participants
35.9 percentage of participants

SECONDARY outcome

Timeframe: DB Day 197, Day 365, Day 533, Day 729

Population: Number of Participants Analyzed=All Treated Population, all participants who entered the open-label period and received at least one dose of abatacept at any time during this period. Treatment groups represent treatment received in the DB period. n=number of participants with data available.

The ACR 20 definition of improvement is a 20% improvement from baseline in the number of tender and swollen joint counts, and a 20% improvement from baseline in 3 of the remaining 5 core set measures: participant global assessment of pain, participant global assessment of disease activity, physician global assessment of disease activity, participant assessment of physical function and acute phase reactant value (C-reactive protein \[CRP\]). The evaluation for 50% improvement (ACR 50) and 70% improvement (ACR 70) follow similarly.

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=132 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
n=136 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
n=104 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
OL; Percentage of Participants With American College of Rheumatology (ACR) Responses Over Time
Day 365, ACR 50 (n=131, n=136, n=102)
55.0 percentage of participants
43.4 percentage of participants
54.9 percentage of participants
OL; Percentage of Participants With American College of Rheumatology (ACR) Responses Over Time
Day 197, ACR 20 (n=130, n=133, n=102)
73.1 percentage of participants
68.4 percentage of participants
44.1 percentage of participants
OL; Percentage of Participants With American College of Rheumatology (ACR) Responses Over Time
Day 197, ACR 50 (n=129, n=134, n=103)
45.7 percentage of participants
42.5 percentage of participants
21.4 percentage of participants
OL; Percentage of Participants With American College of Rheumatology (ACR) Responses Over Time
Day 533, ACR 20 (n=128, n=128, n=102)
82.8 percentage of participants
82.8 percentage of participants
74.5 percentage of participants
OL; Percentage of Participants With American College of Rheumatology (ACR) Responses Over Time
Day 533, ACR 50 (n=129, n=128, n=103)
58.1 percentage of participants
57.0 percentage of participants
47.6 percentage of participants
OL; Percentage of Participants With American College of Rheumatology (ACR) Responses Over Time
Day 533, ACR 70 (n=129, n=127, n=102)
35.7 percentage of participants
40.9 percentage of participants
32.4 percentage of participants
OL; Percentage of Participants With American College of Rheumatology (ACR) Responses Over Time
Day 729, ACR 20 (n=119, n=127, n=102)
86.6 percentage of participants
84.3 percentage of participants
76.5 percentage of participants
OL; Percentage of Participants With American College of Rheumatology (ACR) Responses Over Time
Day 729, ACR 50 (n=117, n=127, n=101)
60.7 percentage of participants
70.9 percentage of participants
49.5 percentage of participants
OL; Percentage of Participants With American College of Rheumatology (ACR) Responses Over Time
Day 729, ACR 70 (n=120, n=127, n=100)
40.8 percentage of participants
44.9 percentage of participants
33.0 percentage of participants
OL; Percentage of Participants With American College of Rheumatology (ACR) Responses Over Time
Day 197, ACR 70 (n=130, n=133, n=103)
23.1 percentage of participants
27.1 percentage of participants
10.7 percentage of participants
OL; Percentage of Participants With American College of Rheumatology (ACR) Responses Over Time
Day 365, ACR 20 (n=130, n=136, n=103)
88.5 percentage of participants
69.1 percentage of participants
75.7 percentage of participants
OL; Percentage of Participants With American College of Rheumatology (ACR) Responses Over Time
Day 365, ACR 70 (n=131, n=136, n=102)
31.3 percentage of participants
23.5 percentage of participants
31.4 percentage of participants

SECONDARY outcome

Timeframe: Defined from the date of achieving ACR 70 response to 6 months post response

Population: Protocol-specified analyses of the proportion of participants achieving a Major Clinical Response were not performed since ACR responses in the open-label period could only be assessed at 6-month intervals due to the fact that CRP and ESR were only measured every 6 months during this period.

Major Clinical Response was defined as a continuous ACR 70 for six months.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: OL Days 197, 253, 281, 309, 337, 365, 449, 533, 617, and 729

Population: Number of Participants Analyzed=All Treated Population, all participants who entered the open-label period and received at least one dose of abatacept at any time during this period. Treatment groups represent treatment received in the DB period.n=number of participants with data available.

The disability section of the full HAQ includes 20 questions to assess physical functions in 8 domains: dressing, arising, eating, walking, hygiene, reach, grip and common activities. The questions are evaluated on a 4-point scale: 0=without any difficulty, 1= with some difficulty, 2= with much difficulty, and 3= unable to do. Higher scores= greater dysfunction. A disability index was calculated by summing the worst scores in each domain and dividing by the number of domains answered. Clinically meaningful HAQ response=an improvement of at least 0.3 units from baseline in HAQ disability Index.

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=132 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
n=136 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
n=104 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
OL; Percentage of Participants With Clinically Meaningful Health Assessment Questionnaire-Disability Index (HAQ-DI) Response Over Time
Day 729 (n=122, n=127, n=103)
74.6 percentage of participants
78.0 percentage of participants
63.1 percentage of participants
OL; Percentage of Participants With Clinically Meaningful Health Assessment Questionnaire-Disability Index (HAQ-DI) Response Over Time
Day 197 (n=131, n=134, n=103)
70.2 percentage of participants
68.7 percentage of participants
42.7 percentage of participants
OL; Percentage of Participants With Clinically Meaningful Health Assessment Questionnaire-Disability Index (HAQ-DI) Response Over Time
Day 225 (n=132, n=133, n=101)
75.0 percentage of participants
72.9 percentage of participants
52.5 percentage of participants
OL; Percentage of Participants With Clinically Meaningful Health Assessment Questionnaire-Disability Index (HAQ-DI) Response Over Time
Day 449 (n=129, n=133, n=101)
70.5 percentage of participants
72.9 percentage of participants
64.4 percentage of participants
OL; Percentage of Participants With Clinically Meaningful Health Assessment Questionnaire-Disability Index (HAQ-DI) Response Over Time
Day 253 (n=130, n=135, n=102)
71.5 percentage of participants
65.2 percentage of participants
57.8 percentage of participants
OL; Percentage of Participants With Clinically Meaningful Health Assessment Questionnaire-Disability Index (HAQ-DI) Response Over Time
Day 309 (n=131, n=134, n=102)
71.0 percentage of participants
70.1 percentage of participants
62.7 percentage of participants
OL; Percentage of Participants With Clinically Meaningful Health Assessment Questionnaire-Disability Index (HAQ-DI) Response Over Time
Day 533 (n=128, n=127, n=103)
74.2 percentage of participants
78.0 percentage of participants
61.2 percentage of participants
OL; Percentage of Participants With Clinically Meaningful Health Assessment Questionnaire-Disability Index (HAQ-DI) Response Over Time
Day 337 (n=130, n=136, n=101)
71.5 percentage of participants
72.1 percentage of participants
63.4 percentage of participants
OL; Percentage of Participants With Clinically Meaningful Health Assessment Questionnaire-Disability Index (HAQ-DI) Response Over Time
Day 281 (n=131, n=135, n=102)
73.3 percentage of participants
71.9 percentage of participants
52.0 percentage of participants
OL; Percentage of Participants With Clinically Meaningful Health Assessment Questionnaire-Disability Index (HAQ-DI) Response Over Time
Day 365 (n=130, n=136, n=103)
70.8 percentage of participants
67.6 percentage of participants
61.2 percentage of participants
OL; Percentage of Participants With Clinically Meaningful Health Assessment Questionnaire-Disability Index (HAQ-DI) Response Over Time
Day 617 (n=123, n=127, n=103)
78.9 percentage of participants
79.5 percentage of participants
64.1 percentage of participants

SECONDARY outcome

Timeframe: Day 1 (Baseline), Day 729

Population: All Treated Population, all participants who entered the open-label period and received at least one dose of abatacept at any time during this period. Treatment groups represent treatment received in the DB period.

The disability section of the full HAQ includes 20 questions to assess physical functions in 8 domains: dressing, arising, eating, walking, hygiene, reach, grip and common activities. The questions are evaluated on a 4-point scale: 0=without any difficulty, 1= with some difficulty, 2= with much difficulty, and 3= unable to do. Higher scores= greater dysfunction. A disability index was calculated by summing the worst scores in each domain and dividing by the number of domains answered. Clinically meaningful HAQ response=an improvement of at least 0.3 units from baseline in HAQ disability Index.

Outcome measures

Outcome measures
Measure
ABA + MTX [DB]
n=122 Participants
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
n=127 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
PLA + MTX [DB]
n=103 Participants
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly)
OL; Adjusted Mean Change From Baseline to Day 729 in HAQ-DI
HAQ-DI
-0.83 units on a scale
Standard Error 0.06
-0.84 units on a scale
Standard Error 0.06
-0.64 units on a scale
Standard Error 0.07
OL; Adjusted Mean Change From Baseline to Day 729 in HAQ-DI
HAQ-DI component: dressing and grooming
-0.93 units on a scale
Standard Error 0.08
-91.0 units on a scale
Standard Error 0.08
-0.68 units on a scale
Standard Error 0.09
OL; Adjusted Mean Change From Baseline to Day 729 in HAQ-DI
HAQ-DI component: arising
-0.8 units on a scale
Standard Error 0.09
-0.77 units on a scale
Standard Error 0.08
-0.72 units on a scale
Standard Error 0.09
OL; Adjusted Mean Change From Baseline to Day 729 in HAQ-DI
HAQ-DI component: hygiene
-0.65 units on a scale
Standard Error 0.10
-0.65 units on a scale
Standard Error 0.08
-0.5 units on a scale
Standard Error 0.09
OL; Adjusted Mean Change From Baseline to Day 729 in HAQ-DI
HAQ-DI component: eating
-0.86 units on a scale
Standard Error 0.09
-0.99 units on a scale
Standard Error 0.09
-0.82 units on a scale
Standard Error 0.10
OL; Adjusted Mean Change From Baseline to Day 729 in HAQ-DI
HAQ-DI component: walking
-0.78 units on a scale
Standard Error 0.09
-0.73 units on a scale
Standard Error 0.08
-0.54 units on a scale
Standard Error 0.08
OL; Adjusted Mean Change From Baseline to Day 729 in HAQ-DI
HAQ-DI component: activities
-0.75 units on a scale
Standard Error 0.09
-0.73 units on a scale
Standard Error 0.09
-0.61 units on a scale
Standard Error 0.09
OL; Adjusted Mean Change From Baseline to Day 729 in HAQ-DI
HAQ-DI component: reach
-0.97 units on a scale
Standard Error 0.09
-0.94 units on a scale
Standard Error 0.10
-0.64 units on a scale
Standard Error 0.09
OL; Adjusted Mean Change From Baseline to Day 729 in HAQ-DI
HAQ-DI component: grip
-0.88 units on a scale
Standard Error 0.09
-0.96 units on a scale
Standard Error 0.09
-0.61 units on a scale
Standard Error 0.09

Adverse Events

ABA (DB)

Serious events: 17 serious events
Other events: 105 other events
Deaths: 0 deaths

ABA + MTX [OL]

Serious events: 90 serious events
Other events: 285 other events
Deaths: 0 deaths

INF + MTX [DB]

Serious events: 30 serious events
Other events: 130 other events
Deaths: 0 deaths

PLA + MTX [DB]

Serious events: 21 serious events
Other events: 82 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
ABA (DB)
n=156 participants at risk
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
ABA + MTX [OL]
n=372 participants at risk
All participants received ABA at a weight-tiered dose of 10 mg/kg plus a stable dose of MTX (minimum 15 mg weekly).
INF + MTX [DB]
n=165 participants at risk
Infliximab was given 3 mg/kg IV (approved labeled dose) on Days 1, 15, 43, 85 and every 56 days thereafter for a total of 8 doses. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
n=110 participants at risk
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly). After placebo treatment from Day 1-197, 104 participants were reallocated to receive abatacept (weight based) plus a stable dose of MTX (minimum 15 mg weekly).
Injury, poisoning and procedural complications
COMPLICATED FRACTURE
0.00%
0/156
0.27%
1/372
0.00%
0/165
0.00%
0/110
Injury, poisoning and procedural complications
ROAD TRAFFIC ACCIDENT
0.64%
1/156
0.00%
0/372
0.00%
0/165
0.00%
0/110
Injury, poisoning and procedural complications
LUMBAR VERTEBRAL FRACTURE
0.00%
0/156
0.27%
1/372
0.00%
0/165
0.00%
0/110
Injury, poisoning and procedural complications
POST PROCEDURAL HAEMATOMA
0.64%
1/156
0.00%
0/372
0.00%
0/165
0.00%
0/110
Eye disorders
CATARACT
0.00%
0/156
0.27%
1/372
0.00%
0/165
0.00%
0/110
Eye disorders
CORNEAL PERFORATION
0.00%
0/156
0.27%
1/372
0.00%
0/165
0.00%
0/110
Investigations
HORMONE LEVEL ABNORMAL
0.00%
0/156
0.27%
1/372
0.00%
0/165
0.00%
0/110
Investigations
ALANINE AMINOTRANSFERASE INCREASED
0.00%
0/156
0.00%
0/372
0.00%
0/165
0.91%
1/110
Investigations
ASPARTATE AMINOTRANSFERASE INCREASED
0.00%
0/156
0.00%
0/372
0.00%
0/165
0.91%
1/110
Cardiac disorders
ARRHYTHMIA
0.00%
0/156
0.27%
1/372
0.00%
0/165
0.00%
0/110
Cardiac disorders
PERICARDITIS
0.00%
0/156
0.00%
0/372
0.00%
0/165
0.91%
1/110
Cardiac disorders
ANGINA PECTORIS
0.64%
1/156
0.27%
1/372
0.61%
1/165
0.00%
0/110
Cardiac disorders
ANGINA UNSTABLE
0.64%
1/156
0.27%
1/372
0.00%
0/165
0.00%
0/110
Cardiac disorders
CARDIAC FAILURE
0.00%
0/156
0.27%
1/372
0.61%
1/165
0.00%
0/110
Cardiac disorders
ATRIAL TACHYCARDIA
0.00%
0/156
0.00%
0/372
0.61%
1/165
0.00%
0/110
Cardiac disorders
MYOCARDIAL INFARCTION
0.00%
0/156
0.81%
3/372
0.00%
0/165
0.00%
0/110
Cardiac disorders
CORONARY ARTERY DISEASE
0.00%
0/156
0.27%
1/372
0.00%
0/165
0.00%
0/110
Cardiac disorders
CORONARY ARTERY OCCLUSION
0.64%
1/156
0.00%
0/372
0.00%
0/165
0.00%
0/110
Cardiac disorders
ACUTE MYOCARDIAL INFARCTION
0.00%
0/156
0.54%
2/372
0.00%
0/165
0.00%
0/110
Vascular disorders
ARTERITIS
0.00%
0/156
0.00%
0/372
0.61%
1/165
0.00%
0/110
Vascular disorders
HAEMATOMA
0.00%
0/156
0.00%
0/372
0.61%
1/165
0.00%
0/110
Vascular disorders
VASCULITIS
0.64%
1/156
0.00%
0/372
0.00%
0/165
0.00%
0/110
Vascular disorders
HYPERTENSION
0.00%
0/156
0.27%
1/372
0.61%
1/165
0.00%
0/110
Vascular disorders
AORTIC STENOSIS
0.00%
0/156
0.27%
1/372
0.00%
0/165
0.00%
0/110
Vascular disorders
HYPERTENSIVE CRISIS
0.64%
1/156
0.00%
0/372
0.00%
0/165
0.00%
0/110
Endocrine disorders
ADRENAL INSUFFICIENCY
0.00%
0/156
0.27%
1/372
0.00%
0/165
0.00%
0/110
Psychiatric disorders
DEPRESSION
0.00%
0/156
0.27%
1/372
0.00%
0/165
0.00%
0/110
Hepatobiliary disorders
BILIARY COLIC
0.00%
0/156
0.00%
0/372
0.61%
1/165
0.00%
0/110
Hepatobiliary disorders
CHOLELITHIASIS
0.64%
1/156
0.54%
2/372
0.61%
1/165
0.00%
0/110
Immune system disorders
ANAPHYLACTIC SHOCK
0.00%
0/156
0.00%
0/372
0.00%
0/165
0.91%
1/110
Nervous system disorders
SCIATICA
0.00%
0/156
0.00%
0/372
0.00%
0/165
0.91%
1/110
Nervous system disorders
CEREBROVASCULAR ACCIDENT
0.64%
1/156
0.00%
0/372
0.00%
0/165
0.00%
0/110
Gastrointestinal disorders
DIARRHOEA
0.00%
0/156
0.00%
0/372
0.00%
0/165
0.91%
1/110
Gastrointestinal disorders
GASTRITIS
0.00%
0/156
0.00%
0/372
0.61%
1/165
0.00%
0/110
Gastrointestinal disorders
ANAL FISSURE
0.00%
0/156
0.27%
1/372
0.00%
0/165
0.00%
0/110
Gastrointestinal disorders
ABDOMINAL PAIN
0.00%
0/156
0.00%
0/372
0.00%
0/165
0.91%
1/110
Gastrointestinal disorders
ANAL SKIN TAGS
0.00%
0/156
0.27%
1/372
0.00%
0/165
0.00%
0/110
Gastrointestinal disorders
INGUINAL HERNIA
0.00%
0/156
0.27%
1/372
0.00%
0/165
0.00%
0/110
Gastrointestinal disorders
UMBILICAL HERNIA
0.00%
0/156
0.00%
0/372
0.00%
0/165
0.91%
1/110
Gastrointestinal disorders
PANCREATITIS ACUTE
0.00%
0/156
0.00%
0/372
0.61%
1/165
0.00%
0/110
Gastrointestinal disorders
HYPERTROPHIC ANAL PAPILLA
0.00%
0/156
0.27%
1/372
0.00%
0/165
0.00%
0/110
Gastrointestinal disorders
UPPER GASTROINTESTINAL HAEMORRHAGE
0.00%
0/156
0.00%
0/372
0.00%
0/165
0.91%
1/110
Ear and labyrinth disorders
VERTIGO
0.00%
0/156
0.00%
0/372
0.00%
0/165
0.91%
1/110
Infections and infestations
SEPSIS
0.00%
0/156
0.00%
0/372
0.00%
0/165
0.91%
1/110
Infections and infestations
ABSCESS
0.00%
0/156
0.27%
1/372
0.00%
0/165
0.00%
0/110
Infections and infestations
PNEUMONIA
1.3%
2/156
0.27%
1/372
1.8%
3/165
0.91%
1/110
Infections and infestations
SINUSITIS
0.64%
1/156
0.00%
0/372
0.00%
0/165
0.00%
0/110
Infections and infestations
BRONCHITIS
0.00%
0/156
0.00%
0/372
0.61%
1/165
0.00%
0/110
Infections and infestations
CELLULITIS
0.00%
0/156
0.81%
3/372
0.61%
1/165
0.00%
0/110
Infections and infestations
ERYSIPELAS
0.00%
0/156
0.27%
1/372
0.61%
1/165
0.00%
0/110
Infections and infestations
APPENDICITIS
0.00%
0/156
0.54%
2/372
0.00%
0/165
0.00%
0/110
Infections and infestations
SEPTIC SHOCK
0.00%
0/156
0.00%
0/372
0.61%
1/165
0.00%
0/110
Infections and infestations
HERPES ZOSTER
0.00%
0/156
0.00%
0/372
0.61%
1/165
0.00%
0/110
Infections and infestations
OSTEOMYELITIS
0.00%
0/156
0.27%
1/372
0.00%
0/165
0.00%
0/110
Infections and infestations
GASTROENTERITIS
0.00%
0/156
0.00%
0/372
0.61%
1/165
0.00%
0/110
Infections and infestations
LOBAR PNEUMONIA
0.00%
0/156
0.00%
0/372
0.61%
1/165
0.00%
0/110
Infections and infestations
WOUND INFECTION
0.00%
0/156
0.27%
1/372
0.00%
0/165
0.00%
0/110
Infections and infestations
BURSITIS INFECTIVE
0.00%
0/156
0.00%
0/372
0.00%
0/165
0.91%
1/110
Infections and infestations
ABSCESS SOFT TISSUE
0.00%
0/156
0.00%
0/372
0.00%
0/165
0.91%
1/110
Infections and infestations
ENCEPHALITIS HERPES
0.00%
0/156
0.00%
0/372
0.61%
1/165
0.00%
0/110
Infections and infestations
INFECTED SKIN ULCER
0.64%
1/156
0.00%
0/372
0.00%
0/165
0.00%
0/110
Infections and infestations
SUBCUTANEOUS ABSCESS
0.00%
0/156
0.27%
1/372
0.00%
0/165
0.00%
0/110
Infections and infestations
NECROTISING FASCIITIS
0.00%
0/156
0.27%
1/372
0.00%
0/165
0.00%
0/110
Infections and infestations
PULMONARY TUBERCULOSIS
0.00%
0/156
0.00%
0/372
0.61%
1/165
0.00%
0/110
Infections and infestations
APPENDICITIS PERFORATED
0.00%
0/156
0.00%
0/372
0.61%
1/165
0.00%
0/110
Infections and infestations
PERITONEAL TUBERCULOSIS
0.00%
0/156
0.00%
0/372
0.61%
1/165
0.00%
0/110
Infections and infestations
URINARY TRACT INFECTION
0.00%
0/156
1.3%
5/372
0.00%
0/165
0.00%
0/110
Infections and infestations
LUNG INFECTION PSEUDOMONAL
0.00%
0/156
0.00%
0/372
0.61%
1/165
0.00%
0/110
Infections and infestations
POSTOPERATIVE WOUND INFECTION
0.00%
0/156
0.00%
0/372
0.61%
1/165
0.91%
1/110
Infections and infestations
PNEUMOCYSTIS JIROVECI PNEUMONIA
0.00%
0/156
0.00%
0/372
0.61%
1/165
0.00%
0/110
Renal and urinary disorders
RENAL FAILURE
0.00%
0/156
0.00%
0/372
0.00%
0/165
0.91%
1/110
Renal and urinary disorders
BLADDER PROLAPSE
0.00%
0/156
0.27%
1/372
0.00%
0/165
0.00%
0/110
Renal and urinary disorders
RENAL IMPAIRMENT
0.00%
0/156
0.00%
0/372
0.00%
0/165
0.91%
1/110
Renal and urinary disorders
STRESS URINARY INCONTINENCE
0.00%
0/156
0.27%
1/372
0.00%
0/165
0.00%
0/110
Metabolism and nutrition disorders
DEHYDRATION
0.00%
0/156
0.27%
1/372
0.00%
0/165
0.91%
1/110
Metabolism and nutrition disorders
HYPOGLYCAEMIA
0.64%
1/156
0.00%
0/372
0.00%
0/165
0.00%
0/110
Metabolism and nutrition disorders
DIABETES MELLITUS
0.00%
0/156
0.27%
1/372
0.00%
0/165
0.00%
0/110
Blood and lymphatic system disorders
ANAEMIA
0.00%
0/156
0.27%
1/372
0.00%
0/165
0.00%
0/110
Blood and lymphatic system disorders
THROMBOCYTOPENIA
0.64%
1/156
0.00%
0/372
0.00%
0/165
0.00%
0/110
Skin and subcutaneous tissue disorders
PSORIASIS
0.00%
0/156
0.27%
1/372
0.00%
0/165
0.00%
0/110
Skin and subcutaneous tissue disorders
URTICARIA
0.00%
0/156
0.00%
0/372
0.61%
1/165
0.00%
0/110
Reproductive system and breast disorders
OVARIAN CYST
0.00%
0/156
0.54%
2/372
0.00%
0/165
0.00%
0/110
Reproductive system and breast disorders
DYSMENORRHOEA
0.00%
0/156
0.27%
1/372
0.00%
0/165
0.00%
0/110
Reproductive system and breast disorders
UTERINE POLYP
0.00%
0/156
0.27%
1/372
0.00%
0/165
0.00%
0/110
Reproductive system and breast disorders
OVARIAN TORSION
0.00%
0/156
0.27%
1/372
0.00%
0/165
0.00%
0/110
Reproductive system and breast disorders
UTERINE PROLAPSE
0.00%
0/156
0.00%
0/372
0.61%
1/165
0.00%
0/110
Injury, poisoning and procedural complications
FALL
0.00%
0/156
0.27%
1/372
0.00%
0/165
0.00%
0/110
Injury, poisoning and procedural complications
ACCIDENT
0.00%
0/156
0.27%
1/372
0.00%
0/165
0.00%
0/110
Injury, poisoning and procedural complications
HIP FRACTURE
0.64%
1/156
0.27%
1/372
0.00%
0/165
0.00%
0/110
Injury, poisoning and procedural complications
ANKLE FRACTURE
0.00%
0/156
0.00%
0/372
0.00%
0/165
0.91%
1/110
Injury, poisoning and procedural complications
ILIUM FRACTURE
0.00%
0/156
0.27%
1/372
0.00%
0/165
0.00%
0/110
Injury, poisoning and procedural complications
TENDON RUPTURE
0.00%
0/156
0.27%
1/372
0.00%
0/165
0.00%
0/110
Injury, poisoning and procedural complications
TIBIA FRACTURE
0.64%
1/156
0.00%
0/372
0.00%
0/165
0.00%
0/110
Injury, poisoning and procedural complications
CARTILAGE INJURY
0.00%
0/156
0.27%
1/372
0.00%
0/165
0.00%
0/110
Injury, poisoning and procedural complications
MULTIPLE INJURIES
0.00%
0/156
0.27%
1/372
0.00%
0/165
0.00%
0/110
Injury, poisoning and procedural complications
FAILURE OF IMPLANT
0.00%
0/156
0.00%
0/372
0.00%
0/165
0.91%
1/110
Injury, poisoning and procedural complications
SUBDURAL HAEMATOMA
0.00%
0/156
0.00%
0/372
0.61%
1/165
0.00%
0/110
Injury, poisoning and procedural complications
ACCIDENTAL OVERDOSE
0.00%
0/156
0.00%
0/372
0.61%
1/165
0.00%
0/110
Injury, poisoning and procedural complications
LOWER LIMB FRACTURE
0.00%
0/156
0.27%
1/372
0.61%
1/165
0.00%
0/110
Injury, poisoning and procedural complications
PUBIC RAMI FRACTURE
0.00%
0/156
0.27%
1/372
0.00%
0/165
0.00%
0/110
Injury, poisoning and procedural complications
UPPER LIMB FRACTURE
0.00%
0/156
0.27%
1/372
0.00%
0/165
0.00%
0/110
Injury, poisoning and procedural complications
CERVICAL VERTEBRAL FRACTURE
0.64%
1/156
0.00%
0/372
0.00%
0/165
0.00%
0/110
Injury, poisoning and procedural complications
POST PROCEDURAL COMPLICATION
0.00%
0/156
0.54%
2/372
0.00%
0/165
0.00%
0/110
Injury, poisoning and procedural complications
DISLOCATION OF JOINT PROSTHESIS
0.00%
0/156
0.27%
1/372
0.00%
0/165
0.00%
0/110
Musculoskeletal and connective tissue disorders
FISTULA
0.00%
0/156
0.27%
1/372
0.00%
0/165
0.00%
0/110
Musculoskeletal and connective tissue disorders
ARTHRITIS
0.00%
0/156
1.1%
4/372
0.00%
0/165
0.00%
0/110
Musculoskeletal and connective tissue disorders
ARTHRALGIA
0.00%
0/156
0.27%
1/372
0.00%
0/165
0.00%
0/110
Musculoskeletal and connective tissue disorders
OSTEONECROSIS
0.64%
1/156
0.54%
2/372
0.00%
0/165
0.00%
0/110
Musculoskeletal and connective tissue disorders
FOOT DEFORMITY
0.00%
0/156
0.27%
1/372
0.00%
0/165
0.00%
0/110
Musculoskeletal and connective tissue disorders
JOINT SWELLING
0.00%
0/156
0.00%
0/372
0.61%
1/165
0.00%
0/110
Musculoskeletal and connective tissue disorders
OSTEOARTHRITIS
0.64%
1/156
1.1%
4/372
0.00%
0/165
1.8%
2/110
Musculoskeletal and connective tissue disorders
RHEUMATOID ARTHRITIS
0.64%
1/156
5.1%
19/372
2.4%
4/165
3.6%
4/110
Musculoskeletal and connective tissue disorders
SPINAL OSTEOARTHRITIS
0.64%
1/156
0.00%
0/372
0.00%
0/165
0.91%
1/110
Musculoskeletal and connective tissue disorders
LUMBAR SPINAL STENOSIS
0.00%
0/156
0.27%
1/372
0.00%
0/165
0.00%
0/110
Musculoskeletal and connective tissue disorders
MUSCULOSKELETAL CHEST PAIN
0.00%
0/156
0.27%
1/372
0.00%
0/165
0.00%
0/110
Musculoskeletal and connective tissue disorders
INTERVERTEBRAL DISC PROTRUSION
0.00%
0/156
0.27%
1/372
0.00%
0/165
0.91%
1/110
Respiratory, thoracic and mediastinal disorders
HAEMOTHORAX
0.00%
0/156
0.27%
1/372
0.00%
0/165
0.00%
0/110
Respiratory, thoracic and mediastinal disorders
LARYNGEAL OEDEMA
0.00%
0/156
0.00%
0/372
0.00%
0/165
0.91%
1/110
Respiratory, thoracic and mediastinal disorders
LARYNGEAL GRANULOMA
0.00%
0/156
0.27%
1/372
0.00%
0/165
0.00%
0/110
Respiratory, thoracic and mediastinal disorders
RESPIRATORY FAILURE
0.00%
0/156
0.27%
1/372
0.61%
1/165
0.00%
0/110
Respiratory, thoracic and mediastinal disorders
SLEEP APNOEA SYNDROME
0.00%
0/156
0.27%
1/372
0.00%
0/165
0.91%
1/110
Respiratory, thoracic and mediastinal disorders
ACUTE RESPIRATORY FAILURE
0.00%
0/156
0.27%
1/372
0.00%
0/165
0.00%
0/110
Respiratory, thoracic and mediastinal disorders
OBSTRUCTIVE AIRWAYS DISORDER
0.00%
0/156
0.27%
1/372
0.00%
0/165
0.00%
0/110
General disorders
PYREXIA
0.64%
1/156
0.54%
2/372
0.00%
0/165
0.00%
0/110
General disorders
HYPERTHERMIA
0.00%
0/156
0.27%
1/372
0.00%
0/165
0.00%
0/110
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
LEIOMYOMA
0.00%
0/156
0.27%
1/372
0.00%
0/165
0.00%
0/110
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
FIBROSARCOMA
0.00%
0/156
0.00%
0/372
0.61%
1/165
0.00%
0/110
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
BLADDER CANCER
0.64%
1/156
0.00%
0/372
0.00%
0/165
0.00%
0/110
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
UTERINE LEIOMYOMA
0.64%
1/156
0.27%
1/372
0.00%
0/165
0.00%
0/110
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
BASAL CELL CARCINOMA
0.00%
0/156
0.27%
1/372
0.00%
0/165
0.91%
1/110
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
BENIGN LUNG NEOPLASM
0.00%
0/156
0.27%
1/372
0.00%
0/165
0.00%
0/110
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
PITUITARY TUMOUR BENIGN
0.00%
0/156
0.27%
1/372
0.00%
0/165
0.00%
0/110
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
SQUAMOUS CELL CARCINOMA
0.00%
0/156
0.27%
1/372
0.00%
0/165
0.00%
0/110
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
MALIGNANT ANORECTAL NEOPLASM
0.00%
0/156
0.00%
0/372
0.61%
1/165
0.00%
0/110
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
BENIGN NEOPLASM OF THYROID GLAND
0.00%
0/156
0.00%
0/372
0.00%
0/165
0.91%
1/110

Other adverse events

Other adverse events
Measure
ABA (DB)
n=156 participants at risk
Abatacept was administered intravenously (IV) on Days 1, 15, 29 and every 28 days thereafter for a total of 14 doses. Administration was as follows: 500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 gram for participants \> 100 kg. All participants received a stable dose of MTX (minimum 15 mg weekly).
ABA + MTX [OL]
n=372 participants at risk
All participants received ABA at a weight-tiered dose of 10 mg/kg plus a stable dose of MTX (minimum 15 mg weekly).
INF + MTX [DB]
n=165 participants at risk
Infliximab was given 3 mg/kg IV (approved labeled dose) on Days 1, 15, 43, 85 and every 56 days thereafter for a total of 8 doses. All participants received a stable dose of MTX (minimum 15 mg weekly).
PLA + MTX [DB]
n=110 participants at risk
Normal saline was administered as placebo. All participants received a stable dose of MTX (minimum 15 mg weekly). After placebo treatment from Day 1-197, 104 participants were reallocated to receive abatacept (weight based) plus a stable dose of MTX (minimum 15 mg weekly).
Investigations
ALANINE AMINOTRANSFERASE INCREASED
3.8%
6/156
2.4%
9/372
2.4%
4/165
5.5%
6/110
Vascular disorders
HYPERTENSION
8.3%
13/156
11.3%
42/372
6.7%
11/165
11.8%
13/110
Psychiatric disorders
ANXIETY
3.2%
5/156
6.5%
24/372
4.2%
7/165
1.8%
2/110
Psychiatric disorders
INSOMNIA
3.2%
5/156
4.0%
15/372
7.3%
12/165
2.7%
3/110
Psychiatric disorders
DEPRESSION
3.8%
6/156
7.0%
26/372
3.6%
6/165
0.91%
1/110
Nervous system disorders
HEADACHE
14.7%
23/156
14.5%
54/372
20.6%
34/165
21.8%
24/110
Nervous system disorders
DIZZINESS
7.1%
11/156
6.7%
25/372
7.9%
13/165
6.4%
7/110
Gastrointestinal disorders
NAUSEA
10.3%
16/156
7.0%
26/372
12.7%
21/165
9.1%
10/110
Gastrointestinal disorders
VOMITING
3.2%
5/156
3.5%
13/372
6.1%
10/165
4.5%
5/110
Gastrointestinal disorders
DIARRHOEA
13.5%
21/156
15.1%
56/372
12.7%
21/165
6.4%
7/110
Gastrointestinal disorders
DYSPEPSIA
12.2%
19/156
11.0%
41/372
10.3%
17/165
6.4%
7/110
Gastrointestinal disorders
GASTRITIS
3.8%
6/156
5.9%
22/372
4.8%
8/165
6.4%
7/110
Gastrointestinal disorders
ABDOMINAL PAIN UPPER
1.9%
3/156
6.2%
23/372
4.8%
8/165
1.8%
2/110
Infections and infestations
INFLUENZA
8.3%
13/156
13.2%
49/372
7.3%
12/165
5.5%
6/110
Infections and infestations
SINUSITIS
6.4%
10/156
7.8%
29/372
4.2%
7/165
7.3%
8/110
Infections and infestations
BRONCHITIS
7.1%
11/156
11.0%
41/372
6.1%
10/165
10.0%
11/110
Infections and infestations
PHARYNGITIS
7.7%
12/156
11.6%
43/372
10.3%
17/165
8.2%
9/110
Infections and infestations
GASTROENTERITIS
2.6%
4/156
6.2%
23/372
7.3%
12/165
5.5%
6/110
Infections and infestations
NASOPHARYNGITIS
12.8%
20/156
18.5%
69/372
15.8%
26/165
13.6%
15/110
Infections and infestations
URINARY TRACT INFECTION
5.1%
8/156
18.0%
67/372
10.9%
18/165
11.8%
13/110
Infections and infestations
UPPER RESPIRATORY TRACT INFECTION
7.1%
11/156
13.4%
50/372
11.5%
19/165
14.5%
16/110
Skin and subcutaneous tissue disorders
RASH
0.64%
1/156
3.2%
12/372
6.1%
10/165
0.91%
1/110
Skin and subcutaneous tissue disorders
PRURITUS
3.2%
5/156
1.3%
5/372
6.1%
10/165
0.91%
1/110
Skin and subcutaneous tissue disorders
URTICARIA
1.9%
3/156
2.7%
10/372
6.7%
11/165
2.7%
3/110
Musculoskeletal and connective tissue disorders
BACK PAIN
7.7%
12/156
11.0%
41/372
6.1%
10/165
7.3%
8/110
Respiratory, thoracic and mediastinal disorders
COUGH
3.8%
6/156
7.5%
28/372
4.2%
7/165
4.5%
5/110
General disorders
OEDEMA PERIPHERAL
5.1%
8/156
4.8%
18/372
3.6%
6/165
4.5%
5/110

Additional Information

BMS Study Director

Bristol-Myers Squibb

Results disclosure agreements

  • Principal investigator is a sponsor employee Bristol-Myers Squibb Co. agreements with investigators vary; constant is our right to embargo communications regarding trial results prior to public release for a period ≤60 days from submittal for review. We will not prohibit investigators from publishing, but will prohibit the disclosure of previously undisclosed confidential information other than study results, and request postponement of single-center publications until after disclosure of the clinical trial's primary publication.
  • Publication restrictions are in place

Restriction type: OTHER