作者
Joel M Kremer, Rene Westhovens, Marc Leon, Eduardo Di Giorgio, Rieke Alten, Serge Steinfeld, Anthony Russell, Maxime Dougados, Paul Emery, Isaac F Nuamah, G Rhys Williams, Jean-Claude Becker, David T Hagerty, Larry W Moreland
发表日期
2003/11/13
期刊
New England Journal of Medicine
卷号
349
期号
20
页码范围
1907-1915
出版商
Massachusetts Medical Society
简介
Background
Effective new therapies are needed for rheumatoid arthritis. Current therapies target the products of activated macrophages; however, T cells also have an important role in rheumatoid arthritis. A fusion protein — cytotoxic T-lymphocyte–associated antigen 4–IgG1 (CTLA4Ig) — is the first in a new class of drugs known as costimulation blockers being evaluated for the treatment of rheumatoid arthritis. CTLA4Ig binds to CD80 and CD86 on antigen-presenting cells, blocking the engagement of CD28 on T cells and preventing T-cell activation. A preliminary study showed that CTLA4Ig may be effective for the treatment of rheumatoid arthritis.
Methods
We randomly assigned patients with active rheumatoid arthritis despite methotrexate therapy to receive 2 mg of CTLA4Ig per kilogram of body weight (105 patients), 10 mg of CTLA4Ig per kilogram (115 patients), or placebo (119 patients) for six months. All …
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