How do the efficacy and safety of abatacept and infliximab compare in the treatment of active RA?

Since the introduction of biologic therapies that target tumor necrosis factor (TNF), short-term and long-term outlooks for many patients with rheumatoid arthritis have greatly improved. Not all patients, however, respond to therapy with these agents. Furthermore, despite favorable overall profiles for safety and tolerability, some concerns remain in this regard. Following the emergence of next-generation biologic agents with new targets, a key question for clinicians concerns the relative efficacy and safety of the different biologic therapies. A study by Schiff et al. directly compared the biologic T-cell costimulation blocker abatacept and the anti-TNF agent infliximab. The results of the 6-month, placebo-controlled trial demonstrated a similar efficacy for both drugs; however, in the 6-month treatment extension period, outcomes of efficacy differed in favor of abatacept. Overall, abatacept had a relatively more-acceptable safety and tolerability profile compared to infliximab.