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Abatacept

Phase 3

Sjogrens Disease | Monoclonal antibody | Immunology |Bristol-Myers Squibb Company|Last Updated: Feb 25, 2026

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Trial Design
RandomizedDouble-BlindPLACEBO_CONTROLLEDDMC
Total Trials1
Total Enrollment250
FDA Designations
No designations recorded
Clinical trial landscape

Abatacept · 50 trials · 33 indications

Phase 3 28Phase 2 11Phase 1 11
NCT04909801A Study to Compare the Response to Treatment With Abatacept vs Adalimumab, on Background Methotrexate, in Adults With Early, Seropositive, and Shared Epitope-positive Rheumatoid Arthritis and an Inadequate Response to MethotrexateRheumatoid Arthritis
ACTIVE NOT_RECRUITING338 Analytics
NCT02971683Trial to Evaluate the Efficacy and Safety of Abatacept in Combination With Standard Therapy Compared to Standard Therapy Alone in Improving Disease Activity in Adults With Active Idiopathic Inflammatory MyopathyPolymyositis
COMPLETED149 Analytics
NCT02915159A Study to Assess the Efficacy and Safety of Abatacept in Adults With Active Primary Sjögrens SyndromeSjogrens Disease
COMPLETED250 Analytics
NCT02504268Effects of Abatacept in Patients With Early Rheumatoid ArthritisRheumatoid Arthritis
COMPLETED994 Analytics
NCT02108860Abatacept for the Treatment of Relapsing, Non-Severe, Granulomatosis With Polyangiitis (Wegener's)Granulomatosis With Polyangiitis (Wegener's)
COMPLETED65 Analytics
NCT02778906Abatacept Reversing Subclinical Inflammation as Measured by MRI in ACPA Positive ArthralgiaArthralgia
COMPLETED98 Analytics
NCT01844518Pharmacokinetics, Efficacy and Safety of Abatacept Administered Subcutaneously (SC) in Children and Adolescents With Active Polyarticular Juvenile Idiopathic Arthritis (pJIA) and Inadequate Response (IR) to Biologic or Non Biologic Disease Modifying Anti-rheumatic Drugs (DMARDs)Active Polyarticular Juvenile Idiopathic Arthritis
COMPLETED219 Analytics
NCT01835470Efficacy, Safety, Pharmacokinetics and Immunogenicity Study of Abatacept Administered Intravenously to Treat Active Polyarticular-course Juvenile Idiopathic Arthritis in JapanJuvenile Idiopathic Arthritis
COMPLETED23 Analytics
NCT01860976Efficacy and Safety of Subcutaneous Abatacept in Adults With Active Psoriatic ArthritisPsoriatic Arthritis
COMPLETED489 Analytics
NCT01844895Methotrexate-Inadequate Response Autoinjector Device Sub StudyRheumatoid Arthritis
COMPLETED120 Analytics
PHASE3ACTIVE NOT_RECRUITING
A Study to Compare the Response to Treatment With Abatacept vs Adalimumab, on Background Methotrexate, in Adults With Early, Seropositive, and Shared Epitope-positive Rheumatoid Arthritis and an Inadequate Response to Methotrexate
Rheumatoid ArthritisUnlock trial analytics
PHASE3COMPLETED
Trial to Evaluate the Efficacy and Safety of Abatacept in Combination With Standard Therapy Compared to Standard Therapy Alone in Improving Disease Activity in Adults With Active Idiopathic Inflammatory Myopathy
PolymyositisUnlock trial analytics
PHASE3COMPLETED
A Study to Assess the Efficacy and Safety of Abatacept in Adults With Active Primary Sjögrens Syndrome
Sjogrens DiseaseUnlock trial analytics
PHASE3COMPLETED
Effects of Abatacept in Patients With Early Rheumatoid Arthritis
Rheumatoid ArthritisUnlock trial analytics
PHASE3COMPLETED
Abatacept for the Treatment of Relapsing, Non-Severe, Granulomatosis With Polyangiitis (Wegener's)
Granulomatosis With Polyangiitis (Wegener's)Unlock trial analytics
PHASE3COMPLETED
Abatacept Reversing Subclinical Inflammation as Measured by MRI in ACPA Positive Arthralgia
ArthralgiaUnlock trial analytics
PHASE3COMPLETED
Pharmacokinetics, Efficacy and Safety of Abatacept Administered Subcutaneously (SC) in Children and Adolescents With Active Polyarticular Juvenile Idiopathic Arthritis (pJIA) and Inadequate Response (IR) to Biologic or Non Biologic Disease Modifying Anti-rheumatic Drugs (DMARDs)
Active Polyarticular Juvenile Idiopathic ArthritisUnlock trial analytics
PHASE3COMPLETED
Efficacy, Safety, Pharmacokinetics and Immunogenicity Study of Abatacept Administered Intravenously to Treat Active Polyarticular-course Juvenile Idiopathic Arthritis in Japan
Juvenile Idiopathic ArthritisUnlock trial analytics
PHASE3COMPLETED
Efficacy and Safety of Subcutaneous Abatacept in Adults With Active Psoriatic Arthritis
Psoriatic ArthritisUnlock trial analytics
PHASE3COMPLETED
Methotrexate-Inadequate Response Autoinjector Device Sub Study
Rheumatoid ArthritisUnlock trial analytics
Study Endpoints
Primary Endpoints
Percentage of SE+ Participants Meeting 50% Improvement in American College of Rheumatology Criteria (ACR50) Response at Week 24
Baseline, week 24

The ACR 50 definition of improvement is a 50% improvement over baseline in tender and swollen joint counts (#1 and #2) and a 50% improvement in 3 of the 5 remaining core data 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). Baseline value is the last assessment taken prior to first dose of single-blind study medication.

Number of Participants Achieving International Myositis Assessment and Clinical Studies Definition of Improvement (IMACS DOI) at Week 24 Without Rescue
From first dose to 24 weeks after first dose. (Approximately 169 days)

The number of participants who achieve IMACS DOI (International Myositis Assessment and Clinical Studies definition of improvement) without rescue medication at week 24. The IMACS DOI is: An improvement of \>/= 20% from baseline in 3 IMACS core measures, no more than 2 IMACS core measure scores worsen by \>/= 25% from baseline, and no more than 2 IMACS core measure scores worsen by \>/= 25% from baseline. IMACS core measures are: Physician Global Assessment of Disease Activity (PGA), Patient (Subject) Global Assessment of Disease Activity (SGA), Manual Muscle Test (MMT-8), Health Assessment Questionnaire-Disability Index (HAQ-DI), Muscle Enzyme levels, Myositis Disease Activity Assessment Tool (MDAAT) Extramuscular Global Activity.

Change From Baseline in EULAR Sjogren's Syndrome Disease Activity Index (ESSDAI)
Day 169

The EULAR Sjögren's Syndrome Disease Activity Index (ESSDAI) total score is calculated as the sum of scores for activity level for each domain. The EULAR Sjögren's Syndrome Disease Activity Index (ESSDAI) Scoring Algorithm. Domain: (Score) Constitutional: (No=0, Low=3, Moderate=6) Lymphadenopathy: (No=0, Low=4, Moderate=8, High=12) Glandular: (No=0, Low=2, Moderate=4) Articular: (No=0, Low=2, Moderate=4, High=6) Cutaneous: (No=0, Low=3, Moderate=6, High=9) Pulmonary: (No=0, Low=5, Moderate=10, High=15) Renal: (No=0, Low=5, Moderate=10, High=15) Muscular: (No=0, Low=6, Moderate=12, High=18) Peripheral Nervous System (PNS): (No=0, Low=5, Moderate=10, High=15) Central Nervous System (CNS): (No=0, Moderate=10, High=15) Haematological: (No=0, Low=2, Moderate=4, High=6) Biological: (No=0, Low=1, Moderate=2) (No = No Disease Activity (DA), Low = Low DA, Moderate = Moderate DA, High = High DA) Overall score, which can range from 0 to 123, a higher score indicates more disease activity

Percentage of Participants in Simple Disease Activity Index (SDAI) Remission at Week 24
Week 24

Simple Disease Activity Index (SDAI) is calculated using the following formula: TJC + SJC + PGA + MDGA + CRP (TJC = number of painful joints from 28 joints, SJC = number of swollen joints from 28 joints, PGA = patient global assessment on a visual analog scale 0-10 cm, MDGA = physician global assessment on a visual analog scale 0-10 cm, and CRP = c-reactive protein in mg/dL) SDAI Remission is defined as SDAI \<= 3.3. Using a logistic regression model that includes treatment arm, randomization stratification factor, and baseline SDAI as continuous variable and point estimate of adjusted ORs, corresponding 95% CI and p-value was provided. SDAI total score range: 0 to 86. SDAI \<= 3.3 indicates disease remission and SDAI \>26 = high disease activity.

Ability of abatacept to reduce the treatment failure rate
12 months

Treatment failure will be defined as relapse, disease worsening, or failure to achieve a Birmingham Vasculitis Activity Score for Wegener's Granulomatosis (BVAS/WG) = 0 or 1 by 6 months. Relapse will be defined as any of the following after remission: an increase in BVAS/WG, development of a new BVAS/WG item, or symptoms/signs of GPA that cannot be attributed to any cause other than GPA and that requires institution or dosage increase of prednisone. Disease worsening will be defined as any of the following prior to remission: an increase in BVAS/WG, development of a new BVAS/WG item, or symptoms/signs of GPA that cannot be attributed to any cause other than GPA and that requires institution or dosage increase of prednisone.

Proportion of patients with an improvement of acute inflammation characterised as improvement of synovitis (synovialitis or tenosynovitis) or osteitis in the MRI of the dominant hand after 6 months of treatment with abatacept or placebo
6 months
Abatacept Trough Concentration (Cmin) in Participants Ages 6 to 17
Day 113

Trough concentration of abatacept (reported as geometric mean of Cmin) in all pharmacokinetic (PK)-evaluable participants. Cmin is reported in microgram per milliliter (µg/mL). Desired target therapeutic Cmin should be \>= 10 µg/mL.

Percentage of Participants Experiencing a American College of Rheumatology (ACR) Pediatric 30 Response at Week 16
Week 16 (Day 113)

American College of Rheumatology (ACR) pediatric (PED) 30 response was defined as '≥30% improvement' and '≥3 of the 6 Juvenile Idiopathic Arthritis (JIA) core set' and ≥30% worsening in not more than 1 of the 6 JIA core set variables. JIA core set variables defined as the number of active joints, number of joints with Limit of Motion (LOM), physician's global assessment of disease severity, patient global assessment of overall well being, parent assessment of physical function, and acute phase reactant value. A non-responder imputation was applied.

Proportion of ACR 20 Responders at Day 169
Day 169

The American College of Rheumatology (ACR) 20 definition of improvement is a 20% improvement over baseline in tender and swollen joint counts and a 20% improvement in 3 of the 5 remaining core data set measures (participant global assessment of pain, participant global assessment of disease activity, physician global assessment of disease activity, participant assessment of physical function, acute phase reactant value). The number of ACR 20 responders was divided by the number of treated participants and expressed as a percentage. Early escape participants, and participants with missing data at day 169 were imputed as non-responders.

Pharmacokinetic (PK) Analysis: Adjusted Geometric Mean Observed Serum Trough Concentration at Steady State (Cminss) of Abatacept Using a Prefilled Syringe (Measured on Day 29) and Using an Autoinjector (Measured on Day 113)
Day 29, Day 113

Abatacept SC was self-administered with a prefilled syringe every 7 days for the first 4 weeks until Day 29; Blood samples for PK were taken pre-dose (0 hour) on Days 29 and 113. Serum concentrations of abatacept were analyzed using a validated enzyme-linked immunosorbent assay (ELISA). Steady-state trough observed concentration in serum (Cminss) was measured in micrograms/milliliter (μg/mL). Adjusted geometric mean and 90% confidence interval (CI) are presented.

Percentage of Participants Who Achieved Remission by Disease Activity Score 28 Based on C-reactive Protein (DAS28-CRP) Criteria at Month 12 and at Both Months 12 and 18
Randomization to Months 12 and 18

DAS28-CRP remission defined as \<2.6; TP=treatment phase; WP=withdrawal phase. The DAS 28-CRP is a measure of disease activity in rheumatoid arthritis (RA) that assesses the 28 joints RA commonly affects; the score includes the number of tender and swollen joints (out of 28), CRP level (a measure of inflammation in the blood), and the patient's global assessment of health (ranging from very good to very bad). These measures are then fed into a complex mathematical formula to produce the overall DAS (a score greater than 5.1 implies active disease; less than 3.2, well controlled disease; and less than 2.6, remission.)

The Proportion of Participants Meeting the American College of Rheumatology (ACR) Criteria of 20% Improvement (ACR20) After 12 Months of Treatment - Intent to Treat Population
Day 1 to Day 365

Proportion(%)=number of participants meeting criteria (n) divided by number of participants who received drug (N). The ACR score indicates degree of improvement in a patient's rheumatoid arthritis (RA), based on guidelines set forth by the ACR and represents a percentage. To qualify a ACR20 score, patient must have \>=20% fewer tender joints and \>=20% fewer swollen joints and show 20% improvement from baseline in at least 3 of: patient overall assessment of his/her RA, physician global assessment of the patient's RA, patient self-assessment of pain, patient self-assessment of physical functioning, and results of an erythrocyte sedimentation rate or C-reactive protein (CRP) test (to assess inflammation). Baseline was Day 1. Randomization was stratified using screening Disease Activity Score-28 (DAS28) CRP, a composite of 4 variables: number of tender joints/28, number of swollen joints/28, CRP in mg/L and participant assessment of disease activity with visual analogue scale.

Mean Change From Baseline in Global Power Doppler Ultrasonography (PDUS) Score Assessing the Metacarpophalangeal (MCP) 2-5 Joints of Both Hands (LOCF Analysis)
Baseline to Days 7, 15, 29, 43, 57, 85, 113, 141, and 169

LOCF=last observation carried forward. PDUS assessed the degree of synovial inflammation of the MCP joints (2nd to 5th) of both hands and was performed at approximately the same time of day for each participant. Total PDUS scores are independent of the presence and grade of joint effusion and are evaluated as follows: Grade 0 or normal=normal joint (no synovial hypertrophy, no Doppler signal); Grade 1 or minimal=minimal synovitis (minimal synovial hypertrophy, with ≤Grade 1 Doppler signal); Grade 2 or moderate=moderate synovitis (moderate synovial hypertrophy with ≤Grade 2 Doppler signal or minimal synovial hypertrophy and Grade 2 Doppler signal; Grade 3 or severe=severe synovitis (severe synovial hypertrophy with ≤Grade 3 Doppler signal or minimal or moderate synovial hypertrophy and Grade 3 Doppler signal). Each joint is rated 1 to 3, for a total possible score ranging from 8 to 24 (8\*1, 8\*3) for 2 hands. Higher grade/score=more severe disease. Change=score Day x - baseline score.

Earliest Time Point at Which Improvement of Core Component of the Global PDUS in the MCP (2-5) Joints of Both Hands Was Assessed
Baseline to Days 7, 15, 29, 43, 57, 85, 113, 141, and 169

MCP=metacarpophalangeal; PDUS=power Doppler ultrasonography. Time point at which early signs of Global PDUS improvement were observed=earliest time point for which 0 was not included in the 95% confidence interval for the mean changes from baseline in Global PDUS (MCP 2-5) score at that and all later time points. Total PDUS scores are independent of the presence and grade of joint effusion: Grade (Gr) 0 or normal=normal joint (no synovial hypertrophy \[SH\], no Doppler signal); Gr 1 or minimal=minimal synovitis (minimal SH, with ≤Gr 1 Doppler signal); Gr 2 or moderate=moderate synovitis (moderate SH, with ≤Gr 2 Doppler signal or minimal SH and grade 2 Doppler signal); Gr 3 or severe=severe synovitis (severe SH with ≤Gr 3 Doppler signal or minimal or moderate SH and Gr 3 Doppler signal). Each joint is rated 1 to 3, for a total possible score ranging from 8 to 24 (8\*1, 8\*3) for the 2 hands. Higher Gr/score=more severe disease.

Number of Participants With Death as Outcome, Serious Adverse Events (SAEs), Treatment-related SAEs, SAEs Leading to Discontinuation, Treatment-related Adverse Events (AEs), AEs Leading to Discontinuation, and AEs of Interest (AEIs) at Day 85
Day 1 (Baseline) through Day 85

An AE is a new or worsening illness, sign, or symptom or a clinically significant abnormal laboratory test result occurring during the study, regardless of causality, and noted by the investigators. Systemic injection reaction occurring ≤ 24 hours after dosing.

Number of Participants With Death As Outcome, Serious Adverse Events (SAEs), Treatment-related SAEs, SAEs Leading to Discontinuation, Treatment-related Adverse Events (AEs), and AEs Leading to Discontinuation
Day 1 (Baseline) through 56 days past last day of subcutaneous injection in the cumulative study period

An AE is a new or worsening illness, sign, or symptom or a clinically significant abnormal laboratory test result occurring during the study, regardless of causality, and noted by the investigators.

Number of Participants With Hematology Laboratory Values Meeting the Criteria for Marked Abnormality
Day 1 (Baseline) through 56 days past last day of subcutaneous injection in the cumulative study period

LLN=lower limit of normal; ULN=upper limit of normal; preRx=pretreatment. Marked abnormality criteria: Hemoglobin (g/dL) \>3 decrease from preRx. Hematocrit (%)\<0.75\*preRx. Erythrocytes (\*10\^6 c/uL) \<0.75\*preRx. Platelet count (\*10\^9 c/L) \<0.67\*LLN or 1.5\*ULN or, if preRx\<LLN, use \<0.5\*preRx and \<100,000 mm\^3. Leukocytes (\*10\^3 c/uL) \<0.75\*LLN or \>1.25\*ULN or, if preRx\<LLN, use \<0.8\*preRx or \>ULN or, if preRx\>ULN, use \>1.2\*preRx or \<LLN. Eosinophils \>0.750\*10\^3 c/uL. Lymphocytes \<0.750\*10\^3 c/uL or \>7.50\*10\^3 c/uL.

Number of Participants With Liver and Kidney Function Laboratory Values Meeting the Criteria for Marked Abnormality
Day 1 (Baseline) through 56 days past last day of subcutaneous injection in the cumulative study period

LLN=lower limit of normal; ULN=upper limit of normal; preRx=pretreatment. Marked abnormality criteria: Alkaline phosphatase (U/L) \>2\*ULN or if preRx\>ULN, use 3\*preRx. Alanine aminotransferase (U/L)\>3\*ULN or if preRx\>ULN, use \>4\*preRx. G-glutamyl transferase (U/L)\>2\*ULN or if preRx\>ULN, use \>3\*preRx. Blood urea nitrogen (mg/dL)\>2\*preRx. Creatinine (mg/dL)\>1.5\*preRx.

Number of Participants With Electrolyte Laboratory Values Meeting the Criteria for Marked Abnormality
Day 1 (Baseline) through 56 days past last day of subcutaneous injection in the cumulative study period

LLN=lower limit of normal; ULN=upper limit of normal; preRx=pretreatment. Sodium: \<0.95\*LLN or \>1.05\*ULN or if preRx\<LLN, \<0.95\*preRx or \>ULN, or if preRx\>ULN,\>1.05\*preRx or \<LLN. Potassium,serum: \<0.9\*LLN or \>1.1\*ULN or if preRx\<LLN, use \<0.9\*preRx or \>ULN or if preRx\>ULN, 1.1\*preRx or \<LLN. Phosphorus: 0.75\*LLN or 1.25\*ULN or, if preRx\<LLN, \<0.67\*preRx or \>ULN or, if preRx\>ULN, \<LLN.

Number of Participants With Chemistry Laboratory Values Meeting the Criteria for Marked Abnormality
Day 1 (Baseline) to up to 56 days past the last day of subcutaneous injection in the cumulative study period

LLN=lower limit of normal; ULN=upper limit of normal; preRX=pretreatment. Criteria for marked abnormality: .

Participants With Urinalysis Values Meeting the Criteria for Marked Abnormality
Day 1 (Baseline) through 56 days past last day of subcutaneous injection in the cumulative study period

preRX=pretreatment. For all values analyzed (protein, urine; glucose, urine; blood, urine: leukocyte esterase, urine; white blood cells, urine; red blood cells, urine): If missing preRx, use \>=2 or, if value \>= 4, or if preRx=0 or 0.5, use \>=2 or, if preRx= 1, use \>=3 or, if preRx=2 or 3, use \>=4.

Number of Participants With Adverse Events of Special Interest
Day 1 (Baseline) to up to 56 days past the last day of subcutaneous injection in the cumulative study period

AEs of special interest are AEs that may be associated with the use of immunomodulatory drugs, such as infections, malignancies, autoimmune disorders, and injection reactions (defined as local injection site reactions and systemic injection reactions occurring within 24 hours of subcutaneous injection).

Mean Sitting Systolic and Diastolic Blood Pressure (BP)
Before injection on Days 1, 29, 57, 85, 169, 253, 365, 449, 533, 617, 729, 813, 897, 981, 1093, 1177, 1261, 1345, 1457, 1541, 1625, 1709, and 1821

BP was measured after the patient had been seated quietly for at least 5 minutes and recorded during the screening visit, during every office visit prior to administration of subcutaneous injections, and at study discharge or 7 days after the last dose for patients who terminated early.

Mean Heart Rate
Before injection on Days 1, 29, 57, 85, 169, 253, 365, 449, 533, 617, 729, 813, 897, 981, 1093, 1177, 1261, 1345, 1457, 1541, 1625, 1709, and 1821

Heart rate was measured after the patient had been seated quietly for at least 5 minutes and recorded during the screening visit, during every office visit prior to administration of subcutaneous injections, and at study discharge or 7 days after the last dose for patients who terminated early.

Mean Temperature
Before injection on Days 1, 29, 57, 85, 169, 253, 365, 449, 533, 617, 729, 813, 897, 981, 1093, 1177, 1261, 1345, 1457, 1541, 1625, 1709, and 1821

Temperature was measured after the patient had been seated quietly for at least 5 minutes and recorded during the screening visit, during every office visit prior to administration of subcutaneous injections, and at study discharge or 7 days after the last dose for patients who terminated early.

Double-blind Period: Number of Participants Achieving American College of Rheumatology (ACR) 20 Response at Day 169
Day 169

The ACR 20 definition of improvement is a 20% improvement from baseline in the number of tender and swollen joints, 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).

Anti-TNF Failure Sub-Study Double Blind Period : Number of Participants With Positive Anti-abatacept or Anti-Cytotoxic T Lymphocyte Antigen 4-T Cell (CTLA4-T) Response in Anti-TNF Failure Population
Days 85, and 169 and postvisits on Days 28, 56, and 85

Serum samples from all treated adult participants with active rheumatoid arthritis who were from the Anti-TNF failure population were screened for the presence of drug-specific antibodies using Enzyme Linked Immunoabsorbant Assay (ELISA). The number of participants who had the presence of anti-abatacept antibodies or anti-CTLA-4 antibodies present in their serum are summarized.

Number of Participants With Anti-abatacept or Anti-CTLA4-T Responses (Enzyme-linked Immunosorbent Assay [ELISA] Method) at Day 113 of the ST Study
Day 113

ELISA is a validated, sensitive assay technique used to analyze presence of abatacept-specific antibodies in serum. For anti-abatacept antibody ELISA, a sample was considered seropositive if it had a titer of 400 or greater and if immunodepletion was observed. The responses that were negative in initial screen were reported as seronegative with a value of \< 400. A sample was considered positive in CTLA4-T antibody ELISA if it had a titer of 25 or greater and if immunodepletion was observed. The responses that were negative in initial screen were reported as seronegative with a value of \< 25.

Number of Participants With Anti-abatacept or Anti-CTLA4-T Responses (ELISA Method) Over Time During the ST Study
Day 15, 29, 43, 57, 85,113 and 28, 56, and 85 days post last dose.

ELISA is a validated, sensitive assay technique used to analyze presence of abatacept-specific antibodies in serum. For anti-abatacept antibody ELISA, a sample was considered seropositive if it had a titer of 400 or greater and if immunodepletion was observed. The responses that were negative in initial screen were reported as seronegative with a value of \< 400. A sample was considered positive in CTLA4-T antibody ELISA if it had a titer of 25 or greater and if immunodepletion was observed. The responses that were negative in initial screen were reported as seronegative with a value of \< 25.

Number of Participants With Positive Anti-abatacept Responses to Abatacept (Meso-Scale Discovery [MSD] Electrochemiluminescence [ECL] Assay Method) Over Time During the ST Study
Day 15, 29, 43, 57, 85,113 and 28, 56 and 85 days post last dose.

The ECL (MSD) assay method is a validated, sensitive assay technique used to analyze presence of abatacept-specific antibodies in serum. It is more sensitive and has a higher drug tolerance than ELISA method. For the anti-abatacept antibody ECL (MSD) assay, a sample was considered seropositive if it had a titer of 10 or greater and if immunodepletion was observed with abatacept, or abatacept and CTLA4-T. Those responses that were not positive in the initial screen or were not confirmed to be positive based on immunodepletion were reported as seronegative and were assigned a value of \< 10.

Immunogenicity in MTX Naive and MTX-previous Users in Cohort 1 at Day 113 of the ST Study (for ELISA Results)
Day 113.

ELISA is a validated, sensitive assay technique used to analyze presence of abatacept-specific antibodies in serum. For anti-abatacept antibody ELISA, a sample was considered seropositive if it had a titer of 400 or greater and if immunodepletion was observed. The responses that were negative in initial screen were reported as seronegative with a value of \< 400. A sample was considered positive in CTLA4-T antibody ELISA if it had a titer of 25 or greater and if immunodepletion was observed. The responses that were negative in initial screen were reported as seronegative with a value of \< 25.

Immunogenicity in MTX Naive and MTX-previous Users in Cohort 1 at Day 113 of the ST Study (for MSD Results)
Day 113.

The ECL (MSD) assay method is a validated, sensitive assay technique used to analyze presence of abatacept-specific antibodies in serum. It is more sensitive and has a higher drug tolerance than the ELISA method. For anti-abatacept antibody ECL (MSD) assay, a sample was considered seropositive if it had a titer of 10 or greater and if immunodepletion was observed with abatacept, or abatacept and CTLA4-T. Those responses that were not positive in the initial screen or were not confirmed to be positive based on immunodepletion were reported as seronegative and were assigned a value of \< 10.

Cross Tabulations of the Number of Participants With Positive and Negative Immunogenicity Status at Baseline and Each Visit During the ST Study (for ELISA Results)
Baseline and on day 15, 29, 43, 57, 85 and 113

ELISA is a validated, sensitive assay technique used to analyze presence of abatacept-specific antibodies in serum. For anti-abatacept antibody ELISA, a sample was considered seropositive if it had a titer of 400 or greater and if immunodepletion was observed. The responses that were negative in initial screen were reported as seronegative with a value of \< 400. A sample was considered positive in CTLA4-T antibody ELISA if it had a titer of 25 or greater and if immunodepletion was observed. The responses that were negative in initial screen were reported as seronegative with a value of \< 25.

Cross Tabulations of the Number of Participants With Positive and Negative Immunogenicity Status at Baseline and Each Visit During the ST Study (for MSD Results)
Baseline and day 15, 29, 43, 57, 85 and 113.

The ECL (MSD) assay method is a validated, sensitive assay technique used to analyze presence of abatacept-specific antibodies in serum . It is more sensitive and has a higher drug tolerance than the ELISA method. For anti-abatacept antibody ECL(MSD) assay, a sample was considered seropositive if it had a titer of 10 or greater and if immunodepletion was observed with abatacept, or abatacept and CTLA4-T. Those responses that were not positive in the initial screen or were not confirmed to be positive based on immunodepletion were reported as seronegative and were assigned a value of \< 10.

Double-blind Withdrawal (DBW) Period; Percentage of Participants With Positive Anti-Abatacept or Anti-Cytotoxic T-Lymphocyte Antigen 4 (CTLA4) Antibody Responses by Enzyme-Linked Immunosorbent Assay (ELISA) at Day 169
Day 169

Serum samples from all treated adult participants with active rheumatoid arthritis (RA) were screened for the presence of drug-specific antibodies using an enzyme-linked immunosorbent assay (ELISA). Immunogenicity was defined as the presence of a positive anti-abatacept or anti-CTLA4 antibody.

Re-introduction (RI) Period; Percentage of Participants With Positive Anti-Abatacept or Anti-CTLA4 Antibody Responses by ELISA at Day 253, by DBW Period Groups
Day 253 (short term)

Serum samples from Abatacept-treated adult participants with active RA were screened for the presence of drug-specific antibodies using ELISA. Immunogenicity was defined as the presence of a positive anti-abatacept or anti-CTLA4 antibody.

Double-blind Period: Mean Synovitis Scores at Baseline As Measured by the Rheumatoid Arthritis Clinical Trials 6 (OMERACT 6) Rheumatoid Arthritis Magnetic Resonance Imaging Score (RAMRIS)
At baseline

Wrist synovitis was assessed by postgadolinium MRI enhancement according to OMERACT 6 RAMRIS in 3 wrist regions: distal radioulnar, radiocarpal, and intercarpal and carpometacarpal joints. For each wrist region, possible score ranges from 0-3, with 0=normal, 1=mild, 2=moderate, and 3=severe damage. The total synovitis score per wrist=the sum of the individual scores for the 3 wrist regions. Minimum score per wrist ranges from 0, indicating no damage, to 9 (score of 3\*3 wrist regions), indicating most severe damage. Change in synovitis = Follow-up synovitis score - baseline score.

Double-blind Period: Mean Change From Baseline in OMERACT 6 Wrist Synovitis Score: Planned Analysis Using Non-Parametric ANCOVA
Baseline to Day 113

Wrist synovitis was assessed by postgadolinium MRI enhancement according to OMERACT 6 RAMRIS in 3 wrist regions: distal radioulnar, radiocarpal, and intercarpal and carpometacarpal joints. For each wrist region, possible score ranges from 0-3, with 0=normal, 1=mild, 2=moderate, and 3=severe damage. The total synovitis score per wrist=the sum of the individual scores for the 3 wrist regions. Minimum score per wrist ranges from 0, indicating no damage, to 9 (score of 3\*3 wrist regions), indicating most severe damage. Change in synovitis=Follow-up synovitis score-baseline score.

Double-blind Period: Mean Change From Baseline in OMERACT 6 Wrist Synovitis Score: Post Hoc Sensitivity Analysis Using Parametric ANCOVA Analysis
Baseline to Day 113

Wrist synovitis was assessed by postgadolinium MRI enhancement according to OMERACT 6 RAMRIS in 3 wrist regions: distal radioulnar, radiocarpal, and intercarpal and carpometacarpal joints. For each wrist region, possible score ranges from 0-3, with 0=normal, 1=mild, 2=moderate, and 3=severe damage. The total synovitis score per wrist=the sum of the individual scores for the 3 wrist regions. Minimum score per wrist ranges from 0, indicating no damage, to 9 (score of 3\*3 wrist regions), indicating most severe damage. Change in synovitis score=Follow-up synovitis score-baseline synovitis score.

Percentage of Participants Meeting the Criteria of the American College of Rheumatology for 20% Improvement (ACR20)
At Day 169

The ACR 20 is based on 20% improvement (compared with baseline values) in tender and swollen joint counts and on 20% improvement 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 1 acute phase reactant value.

Long-term Extension (LTE) (Open-Label) Period: Number of Participants With Death as Outcome, Serious Adverse Events (SAEs), Related SAEs, Discontinuatons Due to SAEs, Adverse Events (AEs), Related AEs, and Discontinuations Due to AEs
Day 169 to up to 56 days post the last dose (Day 1485) in the LTE period

AE=any new untoward medical occurrence or worsening of a preexisting medical condition which does not necessarily have a causal relationship with this treatment. Related AE=relationship of certain, probable, possible, or missing. 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 the development of drug dependency or drug abuse, is an important medical event.

Time to Disease Relapse Through Month 12 (Kaplan-Meier Cumulative Percentage of Events of Disease Relapse)
Months 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12

An event of disease relapse was defined as additional Disease-modifying antirheumatic drug (DMARD) therapy given, or 2 or more courses of high steroids given, or return to abatacept 10 mg/kg (rescue medication given), or DAS28 C-reactive protein (CRP) score \>=3.2 at 2 consecutive visits. Time to disease relapse was evaluated using life tables (Kaplan-Meier Cumulative Percentage of Events of Disease Relapse).

Number of Participants With Adverse Events (AE), Serious Adverse Events (SAE), and Discontinuations Due to AEs
From initiation of the study drug (31 Mar 2008) to data cutoff (27 Dec 2010). The overall mean duration of exposure to the study drug was approximately 3 years (34.3 ± 10.7 months).

AE is defined as any new untoward medical occurrence or worsening of a pre-existing medical condition. SAE is 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 cancer, is a congenital anomaly/birth defect, results in the development of drug dependency or drug abuse, is an important medical event. Both subjective and objective AEs and SAEs are included.

Number of Participants With Abnormal Laboratory Changes (ALC)
From initiation of the study drug (31 Mar 2008) to data cutoff (27 Dec 2010). The overall mean duration of exposure to the study drug was approximately 3 years (34.3 ± 10.7 months).

The laboratory tests were analyses included enzyme, gastrointestinal, hematology, hepatobiliary, lipid, metabolic, nutritional, blood gas, microbiology, serology, protein, chemistry, renal, urinary tract, urinalyses, water, electrolyte and mineral investigations.

Number of Participants With Vital Signs, Physical Examinations, and Electrocardiogram Findings That Were Considered to be AEs by the Investigator
At week 0, 2, 4; then once every 4 weeks up to 48 months; then once in every 3 months or 12 weeks to end of study (27 Dec 2010). The overall mean duration of exposure to the study drug was approximately 3 years (34.3 ± 10.7 months).
Induction Period (IP); Number of Participants With Clinical Response (Per Mayo Score) at Week 12: IP Cohort 1 (IP1C)
Week 12 (Day IP-85)

The Mayo Scoring system ranges from 0 - 12 points and is a composite index consisting of 4 disease variables (stool frequency, rectal bleeding, endoscopy evaluation, and Physician's Global Assessment). Higher Mayo scores indicate greater severity of disease. A clinical response is defined as a reduction from baseline in the Mayo score of ≥ 3 points and ≥ 30%, with an accompanying decrease in the rectal bleeding subscore of ≥ 1 point or absolute rectal bleeding subscore of ≤ 1 point.

Maintenance Period (MP); Number of Participants With Clinical Response (Per Mayo Score) at Month 12
Month 12 (Day MP-365)

The Mayo Scoring system ranges from 0 - 12 points and is a composite index consisting of 4 disease variables (stool frequency, rectal bleeding, endoscopy evaluation, and Physician's Global Assessment). Higher Mayo scores indicate greater severity of disease. A clinical response is defined as a reduction from baseline in the Mayo score of ≥ 3 points and ≥ 30%, with an accompanying decrease in the rectal bleeding subscore of ≥ 1 point or absolute rectal bleeding subscore of ≤ 1 point.

Open-Label Extension Period (OL); Number of Participants With Adverse Events (AEs), Related AEs, Deaths, Serious AEs (SAEs), Related SAEs, and AEs Leading to Discontinuation
Day OL-1 through the end of the OL

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. Related AE=relationship of certain, probable, possible, or missing. 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.

OL; Number of Participants With AEs of Special Interest
Day OL-1 through Day OL-729

AE=any new untoward medical occurrence or worsening of a pre-existing medical condition which does not necessarily have a causal relationship with this treatment. AEs of special interest are those AEs that may be associated with the use of immunomodulatory drugs, including all infections, serious infections, and opportunistic infections; autoimmune disorders; neoplasms; acute infusional AEs (pre-specified AEs occurring within 1 hour of start of infusion) and peri-infusional AEs (pre-specified AEs occurring within 24 hours of the start of infusion).

OL; Number of Participants With Physical Examination Findings
Day OL-1 through Day OL-729

Complete physical examination was obtained at the Screening Visit, Day MP-365, and OL Final Visit/Early Termination visits. Interim physical examinations were performed at other study visits. Interim physical exam were not as comprehensive as the initial full examination but did note any changes in the participant's condition since the last assessment and did not preclude examination of any of the body systems as clinically indicated. Participants were observed for AEs and vital signs (blood pressure, heart rate, and temperature).

OL; Number of Participants With Marked Hematology Laboratory Abnormalities
Day OL-1 through Day OL-729

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; eosinophils: \>0.750 x 10\^3 c/uL; monocytes: \>2000 mm3; lymphocytes: \<0.750 x 10\^3 c/uL/ \>7.50 x 10\^3 c/uL.

OL; Number of Participants With Liver and Kidney Function and Electrolyte Laboratory Abnormalities
Day OL-1 through Day OL-729

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; potassium (K): \<0.9 x LLN/ \>1.1 x ULN; calcium (Ca): \<0.8 x LLN/\>1.2 x ULN; phosphorous (P): \<0.75 x LLN/ \>1.2 5 x ULN

OL; Number of Participants With Chemistry and Urinalysis Laboratory Abnormalities
Day OL-1 through Day OL-729

Low=lower than LLN, High=greater than ULN. LLN/ULN= serum glucose (Glu): \<65 mg/dL/ \>220 mg/dL; fasting serum Glu: \<0.8 x LLN/ \>1.5 x ULN; total protein: \< 0.9 x LLN/ \>1.1 x ULN; albumin:\<0.9 x LLN; uric acid: \>1.5 x ULN. For Urinalysis (Urine protein, urine Glu, urine blood, leukocyte esterase, Red Blood Cells \[RBCs\], White Blood Cells \[WBCs\]): Use ≥2 when BL value missing or value ≥4, or when pre-dose=0 or 0.5. Use ≥3 when pre-dose=1. Use ≥4 when pre-dose=2 or 3

Number of Participants in DAS 28 C-reactive Protein (CRP) Remission at Month 12
Month 12

Number of participants who achieved remission at Month 12 of treatment, as defined by a Disease Activity Score (DAS) 28-CRP score of \<2.6. DAS 28-CRP is a continuous measure, a composite of 4 variables: number of tender joints out of 28 joints, number of swollen joints out of 28 joints, CRP (in mg/L), and subject assessment of disease activity measure on a Visual Analogue Scale (VAS) of 100 millimeters (mm). The DAS28 scale=0 (best) to 10 (worst), indicating the current activity of the rheumatoid arthritis. A DAS28 \>5.1 = high disease activity; \<=3.2 = low disease activity; \<2.6 = remission.

Mean Change From Baseline in Radiographic Total Score to Month 12
Baseline, Month 12

To assess joint damage progression, the Genant-modified Sharp scoring method was used to evaluate radiographs of hands/wrists and feet for erosions and joint space narrowing (JSN). The total Genant-modified Sharp score ranges from 0 (no radiographic damage) to 290 (worst possible radiographic damage) and is the sum of the erosion score (range 0-145) and the joint space narrowing score (range 0-145). Higher scores indicated more damage.

Number of Subjects With Adverse Events (AEs), Serious Adverse Events (SAEs), Deaths, and Discontinuations Due to AEs During the Open-Label Period
Continuously through open-label period (from Month 12 to Month 24). Includes data up to 56 days post last dose in the open-label period or start of the maintenance sub-study, whichever occurred first.

AE=any new untoward medical occurrence or worsening of a pre-existing medical condition in a subject administered an investigational product and that does not necessarily have a causal relationship with this treatment. Related AE/SAE=Certain, Probable, Possible, or Missing. SAE=any untoward medical occurrence that results in death, is life-threatening, requires or prolongs inpatient hospitalization (including elective surgery), results in persistent or significant disability/incapacity, is a congenital anomaly/birth defect, or is an important medical event.

Number of Participants With Serious Adverse Events Reported During the Open-Label Period
Continuously through open-label period (from Month 12 to Month 24). Includes data up to 56 days post last dose in the open-label period or start of the maintenance sub-study, whichever occurred first.

SAE=any untoward medical occurrence that results in death, is life-threatening, requires or prolongs inpatient hospitalization (including elective surgery), results in persistent or significant disability/incapacity, is a congenital anomaly/birth defect, or is an important medical event.

Number of Participants With SAEs With an Outcome of Death During the Open-label Period
Continuously through open-label period (from Month 12 to Month 24). Includes data up to 56 days post last dose in the open-label period or start of the maintenance sub-study, whichever occurred first.

Any untoward medical occurrence (SAE) that resulted in death

Incidence Rates of Autoimmune Disorders in ABA-Treated Participants
Double Blind Period (+56 days post last dose in double-blind period or start of open-label period, whichever came first). Open-label period (56 days post last dose in the open-label period or start of maintenance sub-study, whichever came first).

The incidence rates of autoimmune disorders are defined as the (number of patients experiencing the event/exposure within the period)\*100 and are expressed in 100 person-years. Subjects experiencing the event had their exposure censored at the time of the 1st event.

Incidence Rates of Infections and Infestations of Adverse Events in ABA-Treated Participants
Double Blind Period (+56 days post last dose in double-blind period or start of the open-label period, whichever came first). Open-label period (56 days post last dose in open-label period or start of maintenance sub-study, whichever came first).

The incidence rates of infections and infestations are defined as the (number of patients experiencing the event /exposure within the period)\*100 and are expressed in 100 person-years. Subjects experiencing the event had their exposure censored at the time of the 1st event.

Incidence Rates of Malignant Neoplasm Adverse Events in ABA-Treated Participants
Double Blind Period (+56 days post last dose in double-blind period or start of the open-label period, whichever came first). Open-label period (56 days post last dose in open-label period or start of maintenance sub-study, whichever came first).

The incidence rates of malignant neoplasms are defined as the (number of patients experiencing the event /exposure within the period)\*100 and are expressed in 100 person-years. Subjects experiencing the event had their exposure censored at the time of the 1st event.

Number of Participants With a Serious Acute-Infusional AE of Anaphylactic Shock During Open-Label Period
Open-Label Period (Month 12 to Month 24)

There were 107 Prespecified, acute-infusional SAEs (occurring within 1 hour after the start of study drug infusion) pre-specified in the protocol; anaphylactic shock was the only one occuring in this study.

Number of Participants With Select Blood Chemistry Laboratory Values Meeting the Marked Abnormality Criteria During the Open-Label Period
Continuously through open-label period (from Month 12 to Month 24). Includes data up to 56 days post last dose in the open-label period or start of the maintenance sub-study, whichever occurred first.

Number of subjects with high liver function and kinedy tests: alkaline phosphatase (ALP) \>2x upper limit of normal (ULN) or if pretreatment (PRE-RX) \>ULN then \>3x PRE-RX; aspartate aminotransferase (AST) \>3x ULN or if PRE-RX \>ULN then \>4x PRE-RX; alanine aminotransferase (ALT) \>3x ULN or if PRE-RX \>ULN then \>4x PRE-RX; g-glutamyl transferase (GGT)\>2x ULN or if PRE-RX \>ULN then \>3x PRE-RX; total bilirubin \>2x ULN or if PRE-RX \>ULN then \>4x PRE-RX; blood urea nitrogen \>2x PRE-RX; creatinine \>1.5x PRE-RX.

Number of Participants With Hematology Laboratory Values Meeting the Marked Abnormality Criteria During the Open-Label Period
Continuously from start of open-label period up to 56 days post the last dose in the open-label period or start of the maintenance sub-study, whichever occurred first.

Marked abnormalities in hemoglobin \>3 g/dL decrease from PRE-RX; hematocrit \<0.75x PRE-RX; erythrocytes \<0.75x PRE-RX; platelet count \<0.67x lower limit of normal (LLN) or \>1.5x ULN or if PRE-RX \<LLN then \<0.5x PRE-RX and \<100,000/mm3; leukocytes \<0.75x LLN or \>1.25x ULN or if PRE-RX \<LLN then \<0.8x PRE-RX or \>ULN if PRE-RX \>ULN then \>1.2x PRE-RX or \<LLN; neutrophils if value \<1.00 x10\^3 c/uL; lymphocytes if value \<.750 x10\^3 c/uL or if value \>7.50 x10\^3 c/uL; monocytes if value \>2000/MM3; basophils if value \>400/mm3; eosinophils if value \>.750 x10\^3 c/uL

Short-term Period: Number of Participants With Death, Serious Adverse Events (SAEs), Related SAEs, SAEs Leading to Discontinuations, AEs, Related AEs, or AEs Leading to Discontinuations
Days 1-169

AE=any new untoward medical occurrence or worsening of a pre-existing medical condition which does not necessarily have a causal relationship with treatment.SAE=any untoward medical occurrence that at any dose: results in death, is life-threatening, requires inpatient hospitalization or causes prolongation of existing hospitalization, results in persistent or significant disability/incapacity, is a congenital anomaly/birth defect, results in development of drug dependency or drug abuse, is an important medical event.Related AE/SAE=Certain,Probable,Possible,or Missing relationship to Drug

Short-term Period: Number of Participants With AEs of Special Interest
Days 1-169

AE=any new untoward medical occurrence or worsening of a pre-existing medical condition which does not necessarily have a causal relationship with this treatment. AEs of special interest are those AEs that may be associated with the use of immunomodulatory drugs, including all infections, serious infections, and opportunistic infections; autoimmune disorders; neoplasms; acute infusional AEs (pre-specified AEs occurring within 1 hour of start of infusion) and peri-infusional AEs (pre-specified AEs occurring within 24 hours of the start of infusion).

Short-term Period: Number of Participants With Hematology Laboratories Meeting Marked Abnormality (MA) Criteria
Days 1-169

Upper Normal Limit (ULN), Lower Normal Limit (LLN), Baseline (BL). Marked abnormality criteria are: Hemoglobin (HGB): \>3 g/dL decrease from BL; Hematocrit: \<0.75 \* BL; Erythrocytes: \<0.75 \* BL; Platelets (PLT): \<0.67 \* LLN/\>1.5 \* ULN, or if BL \< LLN then use 0.5 \* BL/\<100,000 mm\^3; Leukocytes: \<0.75 \* LLN/ \>1.25 \* ULN, or if BL\<LLN then use \<0.8 \* BL/\>ULN, or if BL\>ULN then use \>1.2 \* BL/\<LLN; neutrophils+bands: \<1.0 \* 10\^3 c/uL; eosinophils: \>0.750 \* 10\^3 c/uL; basophils: \> 400 mm\^3; monocytes: \>2000 mm\^3; lymphocytes: \<0.750 \* 10\^3 c/uL/ \>7.50 \* 10\^3 c/uL.

Short-term Period: Number of Participants With Liver and Kidney Function Laboratories Meeting MA Criteria
Days 1-169

Marked abnormality criteria: Alkaline phosphatase (ALP): \>2\* ULN, or if BL\>ULN then use \>3\* BL; aspartate aminotransferase (AST): \>3\* ULN, or if BL\>ULN then use \>4\* BL; alanine aminotransferase (ALT): \>3\* ULN, or if BL\>ULN then use \>4\* BL; G-Glutamyl transferase (GGT): \>2\* ULN, or if BL\>ULN then use \>3\* BL; Bilirubin: \>2\* ULN, or if BL\>ULN then use \>4\* BL; blood urea nitrogen (BUN): \>2\* BL; creatinine: \>1.5\* BL

Short-term Period: Number of Participants With Electrolyte Laboratories Meeting MA Criteria
Days 1-169

Marked abnormality criteria:Sodium (Na): \<0.95\* LLN/ \>1.05\* ULN,or if BL\<LLN then use 0.95\* BL or \>ULN,or if BL\>ULN then use\>1.05\* BL or \<LLN; potassium (K): \<0.9\* LLN/\>1.1\* ULN,or if BL\<LLN then use 0.9\* BL or \>ULN, or if BL\>ULN then use\>1.1\* BL or \<LLN; chloride: \<0.9\* LLN/\>1.1\* ULN, or if BL\<LLN then use 0.9\* BL or \>ULN, or if BL\>ULN then use\>1.1\* BL or \<LLN; calcium (Ca): \<0.8\* LLN/\>1.2\* ULN, or if BL\<LLN then use 0.75\* BL or \>ULN, or if BL\>ULN then use\>1.25\* BL or \<LLN; phosphorous (P): \<0.75\* LLN/ \>1.25\* ULN, or if BL\<LLN then use 0.67\* BL or \>ULN, or if BL\>ULN then use\>1.33\* BL or \<LLN

Short-term Period: Number of Participants With Other Chemistry and Urinalysis Laboratories Meeting MA Criteria
Days 1-169

Marked abnormality criteria: serum glucose (Glu):\<65 mg/dL/ \>220 mg/dL; fasting serum Glu: \<0.8\* LLN/\>1.5\* ULN, or if BL\<LLN then use 0.8\* BL or \>ULN, or if BL\>ULN then use \>2.0\* BL or \<LLN; total protein: \<0.9\* LLN/\>1.1\* ULN; albumin: \<0.9\* LLN,or if BL\<LLN then use \<0.75 BL; uric acid: \>1.5\* ULN, or if BL\>ULN then use \>2\* BL. Urinalysis (Urine protein, urine Glu, urine blood, leukocyte esterase, Red Blood Cells \[RBCs\], White Blood Cells \[WBCs\]):Use ≥2 when BL value missing or value ≥4,or when pre-dose=0 or 0.5. Use ≥3 when pre-dose=1. Use ≥4 when pre-dose=2 or 3

Short-term Period: Mean Change From Baseline in Systolic and Diastolic Blood Pressure
Day 1 (Baseline) -Day 169
Short-term Period: Number of Participants With Positive Anti-Abatacept or Anti-Cytotoxic T-Lymphocyte Antigen 4 (CTLA4) Responses by Enzyme-Linked Immunosorbant Assay (ELISA)
Days 1-169

Serum samples from all treated adult participants with active rheumatoid arthritis (RA) were screened for the presence of drug-specific antibodies using ELISA. Immunogenicity was defined as the presence of a positive anti-abatacept or anti-CTLA4 antibody.

Long-term Period: Number of Participants With Death, Serious Adverse Events (SAEs), Related SAEs, SAEs Leading to Discontinuations, AEs, Related AEs, or AEs Leading to Discontinuations
From Day 169 through Day 813, including up to 56 days after the last dose of long-term period abatacept

AE=any new untoward medical occurrence or worsening of a pre-existing medical condition which does not necessarily have a causal relationship with treatment.SAE=any untoward medical occurrence that at any dose: results in death, is life-threatening, requires inpatient hospitalization or causes prolongation of existing hospitalization, results in persistent or significant disability/incapacity, is a congenital anomaly/birth defect, results in development of drug dependency or drug abuse, is an important medical event.Related AE/SAE=Certain,Probable,Possible,or Missing relationship to Drug

Long-term Period: Number of Participants With AEs of Special Interest
From Day 169 through Day 813, including up to 56 days after the last dose of long-term period abatacept

AE=any new untoward medical occurrence or worsening of a pre-existing medical condition which does not necessarily have a causal relationship with this treatment. AEs of special interest are those AEs that may be associated with the use of immunomodulatory drugs, including all infections, serious infections, and opportunistic infections; autoimmune disorders; neoplasms; acute infusional AEs (pre-specified AEs occurring within 1 hour of start of infusion) and peri-infusional AEs (pre-specified AEs occurring within 24 hours of the start of infusion).

Long-term Period: Number of Participants With Hematology Laboratories Meeting Marked Abnormality (MA) Criteria
From Day 169 through Day 813, including up to 56 days after the last dose of long-term period abatacept

ULN=upper limit of normal; LLN=lower limit of normal; BL=baseline. Marked abnormality criteria=Hemoglobin: \>3 g/dL decrease from BL; Hematocrit: \<0.75\*BL; Erythrocytes:\<0.75\*BL; Platelets: \<0.67\*LLN/\>1.5 \* ULN, or if BL\<LLN, use 0.5\*BL/\<100,000 mm\^3; Leukocytes: \<0.75\*LLN/\>1.25\*ULN, or if BL\<LLN, use \<0.8\*BL/\>ULN, or if BL\>ULN,use \>1.2\*BL/\<LLN; neutrophils+bands: \<1.0\*10\^3 c/uL; eosinophils: \>0.750\*10\^3 c/uL; basophils: \>400 mm\^3; monocytes: \>2000 mm\^3; lymphocytes: \<0.750\*10\^3 c/uL/\>7.50\*10\^3 c/uL.

Long-term Period: Number of Participants With Liver and Kidney Function Laboratories Meeting MA Criteria
From Day 169 through Day 813, including up to 56 days after the last dose of long-term period abatacept

Marked abnormality criteria: Alkaline phosphatase (ALP): \>2\*ULN, or if BL\>ULN, use \>3\*BL; aspartate aminotransferase (AST): \>3\*ULN, or if BL\>ULN,use \>4\*BL; alanine aminotransferase (ALT): \>3\*ULN, or if BL\>ULN, use \>4\*BL; G-Glutamyl transferase (GGT): \>2\*ULN, or if BL\>ULN, use \>3\*BL; bilirubin: \>2\*ULN, or if BL\>ULN, use \>4\*BL; blood urea nitrogen (BUN): \>2\*BL; creatinine: \>1.5\*BL

Long-term Period: Number of Participants With Electrolyte Laboratories Meeting MA Criteria
From Day 169 through Day 813, including up to 56 days after the last dose of long-term period abatacept

Marked abnormality criteria:Sodium (Na): \<0.95\* LLN/ \>1.05\* ULN,or if BL\<LLN then use 0.95\* BL or \>ULN,or if BL\>ULN then use\>1.05\* BL or \<LLN; potassium (K): \<0.9\* LLN/\>1.1\* ULN,or if BL\<LLN then use 0.9\* BL or \>ULN, or if BL\>ULN then use\>1.1\* BL or \<LLN; chloride: \<0.9\* LLN/\>1.1\* ULN, or if BL\<LLN then use 0.9\* BL or \>ULN, or if BL\>ULN then use\>1.1\* BL or \<LLN; calcium (Ca): \<0.8\* LLN/\>1.2\* ULN, or if BL\<LLN then use 0.75\* BL or \>ULN, or if BL\>ULN then use\>1.25\* BL or \<LLN; phosphorous (P): \<0.75\* LLN/ \>1.25\* ULN, or if BL\<LLN then use 0.67\* BL or \>ULN, or if BL\>ULN then use\>1.33\* BL or \<LLN

Long-term Period: Number of Participants With Other Chemistry and Urinalysis Laboratories Meeting MA Criteria
From Day 169 through Day 813, including up to 56 days after the last dose of long-term period abatacept

Marked abnormality criteria: serum glucose (Glu):\<65 mg/dL/ \>220 mg/dL; fasting serum Glu: \<0.8\* LLN/\>1.5\* ULN, or if BL\<LLN then use 0.8\* BL or \>ULN, or if BL\>ULN then use \>2.0\* BL or \<LLN; total protein: \<0.9\* LLN/\>1.1\* ULN; albumin: \<0.9\* LLN,or if BL\<LLN then use \<0.75 BL; uric acid: \>1.5\* ULN, or if BL\>ULN then use \>2\* BL. Urinalysis (Urine protein, urine Glu, urine blood, leukocyte esterase, Red Blood Cells \[RBCs\], White Blood Cells \[WBCs\]):Use ≥2 when BL value missing or value ≥4,or when pre-dose=0 or 0.5. Use ≥3 when pre-dose=1. Use ≥4 when pre-dose=2 or 3

Long-term Period: Change From Baseline in Hemoglobin (HGB), Total Protein, and Albumin Over Time
BL, Day 365, Day 729

HGB normal range (NR)=11.6 - 16.2 g/dL, marked abnormality (MA) is \>3 g/dL decrease from BL. Total protein NR=6.0 - 8.4 g/dL, MA is \<0.9\* LLN/\>1.1\* ULN; Albumin NR=3.5 - 5.3 g/dL, MA is \<0.9\* LLN, or if BL\<LLN then use \<0.75 BL

Long-term Period: Change From Baseline in Hematocrit Over Time
BL, Day 365, Day 729

The hematocrit value refers to the percentage of blood volume that is occupied by red blood cells. Hematocrit values for participants were expressed as percentages and were averaged to yield a group mean value (percentage) at a particular time point. The mean change from baseline in hematocrit value (expressed as a percent)= mean post-baseline value (expressed as a percent) - mean baseline value (expressed as a percent).

Long-term Period: Change From Baseline in Erythrocytes Over Time
BL, Day 365, Day 729

Erythrocytes NR= 3.80 - 5.50 \*10\^6 c/uL, MA is \<0.75 \* BL

Long-term Period: Change From Baseline in Platelets (PLT) Over Time
BL, Day 365, Day 729

Erythrocytes NR= 3.80 - 5.50 \*10\^6 c/uL, MA is \<0.75 \* BL

Long-term Period: Change From Baseline in White Blood Cells Over Time
BL, Day 365, Day 729

Leukocytes NR=4.1 - 12.3\*10\^3 c/uL, MA is \<0.75 \* LLN/ \>1.25 \* ULN, or if BL\<LLN then use \<0.8 \* BL/\>ULN, or if BL\>ULN then use \>1.2 \* BL/\<LLN. Neutrophils+bands MA is \<1.0 \* 10\^3 c/uL. Eosinophils MA is \>0.750 \* 10\^3 c/uL. Basophils MA is \> 400 mm\^3. Monocytes MA is \>2000 mm\^3. Lymphocytes MA is \<0.750 \* 10\^3 c/uL/ \>7.50 \* 10\^3 c/uL

Long-term Period: Change From Baseline in Alkaline Phosphatase (ALP), Aspartate Aminotransferase (AST), Alanine Aminotransferase (ALT), and G-Glutamyl Transferase (GGT) Over Time
BL, Day 365, Day 729

HGB normal range (NR)=11.6 - 16.2 g/dL, marked abnormality (MA) is \>3 g/dL decrease from BL. Total protein NR=6.0 - 8.4 g/dL, MA is \<0.9\* LLN/\>1.1\* ULN; Albumin NR=3.5 - 5.3 g/dL, MA is \<0.9\* LLN, or if BL\<LLN then use \<0.75 BL

Long-term Period: Change From Baseline in Bilirubin, Blood Urea Nitrogen (BUN), Creatinine, Calcium (Ca), Phosphorus (P), Serum Glucose (Glu), and Uric Acid Over Time
BL, Day 365, Day 729

Bilirubin NR=0.2-1.2 mg/dL, MA: \>2\* ULN, or if BL\>ULN then use \>4\* BL. BUN NR=4.0-24.0 mg/dL, MA: \>2\*BL. Creatinine NR=0.4-1.2 mg/dL, MA: \>1.5\*BL. Ca NR=8.8-10.2 mg/dL, MA: \<0.8\*LLN/\>1.2\*ULN, or if BL\<LLN then use 0.75\*BL or \>ULN, or if BL\>ULN then use\>1.25\*BL or \<LLN. P NR=2.8-4.0 mg/dL, MA: \<0.75\*LLN/ \>1.25\*ULN, or if BL\<LLN then use 0.67\*BL or \>ULN, or if BL\>ULN then use\>1.33\*BL or \<LLN. Glu MA: \<65 mg/dL/ \>220 mg/dL. Uric acid MA: \>1.5\*ULN, or if BL\>ULN then use \>2\*BL.

LT; Change From Baseline in Sodium (Na), Potassium (K), Chloride (Cl) Over Time
BL, Day 365, Day 729

Na NR=132 - 147 mEq/L, MA is 95\* LLN/ \>1.05\* ULN, or if BL\<LLN then use 0.95\* BL or \>ULN, or if BL\>ULN then use\>1.05\* BL or \<LLN. K NR=3.3 - 5.5 mEq/L, MA is \<0.9\* LLN/\>1.1\* ULN,or if BL\<LLN then use 0.9\* BL or \>ULN, or if BL\>ULN then use\>1.1\* BL or \<LLN. Cl NR=94 - 111 mEq/L, MA is \<0.9\* LLN/\>1.1\* ULN, or if BL\<LLN then use 0.9\* BL or \>ULN, or if BL\>ULN then use\>1.1\* BL or \<LLN

Long-term Period: Mean Sitting Systolic Blood Pressure (SBP) Over Time
From Day 169 through Day 813, including up to 56 days after the last dose of long-term period abatacept

Measurements were taken in a seated position before and after abatacept infusion.

Long-term Period: Mean Sitting Diastolic Blood Pressure (DBP) Over Time
From Day 169 through Day 813, including up to 56 days after the last dose of long-term period abatacept

Measurements were taken in a seated position before and after abatacept infusion.

Long-term Period: Mean Heart Rate (HR) Over Time
From Day 169 through Day 813, including up to 56 days after the last dose of long-term period abatacept
Long-term Period: Mean Temperature (T) Over Time
From Day 169 through Day 813, including up to 56 days after the last dose of long-term period abatacept
Time to Occurrence of Juvenile Rheumatoid Arthritis/Juvenile Idiopathic Arthritis (JRA/JIA) Disease Flare During Double-Blind Phase (Period B)
Period B (Day 113 to Day 282)

Time to flare is defined as the elapsed number of days between the first dose date in Period B and the study day that disease flare is confirmed. All of the following criteria must be met to be defined as a flare: * \> 30% worsening in at least 3 of the 6 JRA/JIA core response variables * \> 30% improvement in not more than 1 of the 6 JRA/JIA core set variables * ≥ 2 cm of worsening must be present if the Physician or Parent Global Assessment is used to define flare * worsening in ≥ 2 joints must be present if the number of active joints or joints with limitation of motion is used to define flare based on changes in the surrogate marker, erythrocyte sedimentation rate (ESR)

Number of American College of Rheumatology 20 (ACR 20) Responders at Day 169
Day 169

ACR 20 response requires a patient to have a 20% reduction in the number of swollen and tender joints, and a reduction of 20% in three of the following five parameters: physician global assessment of disease, patient global assessment of disease, patient assessment of pain, C-reactive protein or erythrocyte sedimentation rate, and degree of disability in Health Assessment Questionnaire (HAQ) score. A participant achieved a sustained ACR 20 response if the participant had ACR 20 observed for at least 2 consecutive study visits.

Number of Participants Achieving Clinically Meaningful Improvement in Health Assessment Questionnaire (HAQ) at Day 365
Day 365

The HAQ-DI includes 20 questions to assess physical function in 8 domains: dressing, arising, eating, walking, hygiene, reach, grip, and common activities. The domain questions are evaluated on a 4-point scale: 0=without any difficulty, 1=with some difficulty, 2=with much difficulty, 3=unable to do. HAQ-DI=sum of worst scores in each domain dividied by the number of domains answered. HAQ-DI ranges from 0 to a maximum overall score of 3.0. Clinically meaningful HAQ response was defined as an improvement of at least 0.3 units from baseline in HAQ DI.

Baseline and Mean Change From Baseline (BL) in Radiographic Erosion Score Results at Day 365
BL (Day 0), Day 365

To assess joint damage progression, the Genant-modified Sharp scoring method was used to evaluate radiographs of hands/wrists and feet for erosions. The erosion score range is 0 (no radiographic damage) to 145 (worst possible radiographic damage). Change from baseline = Post-baseline - Baseline value

Participants With Deaths, Adverse Events (AEs) and SAEs in the Open-Label (OL) Period
Day 365 to Day 2,185

AE was defined as 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 was defined as 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.

Participants With Hematology Values Meeting the Marked Abnormality Criteria in the OL Period
Day 365 to Day 2,185

Marked abnormality criteria are: Hemoglobin (HGB): \>3 g/dL decrease from BL; Hematocrit: \<0.75 \* BL; Erythrocytes: \<0.75 \* BL; Platelets (PLT): \<0.67 \* LLN/\>1.5 \* ULN, or if BL \< LLN then use \<0.5 \* BL and \<100,000 mm\^3; Leukocytes: \<0.75 \* LLN/ \>1.25 \* ULN, or if BL\<LLN then use \<0.8 \* BL or \>ULN, or if BL\>ULN then use \>1.2 \* BL or \<LLN; neutrophils+bands: \<1.0 \* 10\^3 c/uL; eosinophils: \>0.750 \* 10\^3 c/uL; basophils: \> 400 mm\^3; monocytes: \>2000 mm\^3; lymphocytes: \<0.750 \* 10\^3 c/uL/ \>7.50 \* 10\^3 c/uL.

Participants With Liver and Kidney Function Values Meeting the Marked Abnormality Criteria in the OL Period
Day 365 to Day 2,185

Marked abnormality criteria are: Hemoglobin (HGB): \>3 g/dL decrease from BL; Hematocrit: \<0.75 \* BL; Erythrocytes: \<0.75 \* BL; Platelets (PLT): \<0.67 \* LLN/\>1.5 \* ULN, or if BL \< LLN then use \<0.5 \* BL and \<100,000 mm\^3; Leukocytes: \<0.75 \* LLN/ \>1.25 \* ULN, or if BL\<LLN then use \<0.8 \* BL or \>ULN, or if BL\>ULN then use \>1.2 \* BL or \<LLN; neutrophils+bands: \<1.0 \* 10\^3 c/uL; eosinophils: \>0.750 \* 10\^3 c/uL; basophils: \> 400 mm\^3; monocytes: \>2000 mm\^3; lymphocytes: \<0.750 \* 10\^3 c/uL/ \>7.50 \* 10\^3 c/uL.

Participants With Electrolyte Values Meeting the Marked Abnormality Criteria in the OL Period
Day 365 to Day 2,185

Sodium \< 0.9 \* LLN or \> 1.05 \* ULN or if BL \< LLN then use \< 0.95 \* BL or \> ULN or if BL \> ULN then use \>1.05 \*BL or \< LLN; Potassium: \< 0.9 \* LLN or \> 1.1 \* ULN or if BL \< LLN then use \< 0.9 \* BL or \> ULN or if BL \> ULN then use 1.1 \* BL or \< LLN; Chloride: \< 0.9 \* LLN or \> 1.1 \* ULN or if BL \< LLN then use \<0.9 \* BL or \>ULN or if BL \> ULN then use \> 1.1 \* BL or \< LLN; Calcium \<0.8 \* LLN or \> 1.2 \* ULN or if BL \< LLN then use \<0.67 \* BL or \> ULN or if BL \> ULN then use \> 1.3 \* BL or \< LLN.

Participants With Glucose, Protein, Metabolites, and Urinalysis Values Meeting the Marked Abnormality Criteria in the OL Period
Day 365 to Day 2,185

Glucose: \< 65 mg/dL or \> 220 mg/dL; Fasting Glucose: \<0.8 \* LLN or \> 1.5 \* ULN or if BL \< LLN then use \< 0.8 \* BL or \> ULN or if BL \> ULN then use 1.1 \* BL or \< LLN; Total protein: \< 0.9 \* LLN or 1.1 \* ULN or if BL \< LLN then use 0.9 \* BL or \> ULN or if BL \> ULN then use 1.1 \* BL or \< LLN; Albumin: \< 0.9 \* LLN or if BL \< LLN then use 0.75 \* BL; Uric acid: \> 1.5 \* ULN or if BL \> ULN then use \> 2.0 \* BL. All urinalysis abnormalities were defined as: if missing BL then use \>= 2 or if value \>=4, or if BL = 0 or 0.5 then use \>= 2, or if BL = 1.0 then use \>= 3, or if BL = 2.0 then use \>=4.

Mean BL Immunoglobulins Over Time in the OL Period
BL (Day 0), Day 365, Day 729, Day 1,093

Mean baseline values are those that are reported for each cohort at each time point on Day 365, Day 729, and Day 1,093.

Mean Change From BL in Immunoglobulins in the OL Period
BL (Day 0), Day 365, Day 729, Day 1,093
Participants With Immunogenicity to Abatacept in the Cumulative DB + OL Period
Day 1 to Day 1,821

Participants with titers to abatacept in the DB and OL periods. Serum samples from abatacept-treated adult participants with active Rheumatoid Arthritis (RA) were screened for the presence of drug-specific antibodies using two validated direct-format enzyme-linked immunosorbent assays (ELISAs) to determine the presence of antibodies to abatacept and or CTLA4-T.

Number of Participants Experiencing Clinically Significant Changes in Vital Signs in the OL Period
Day 365 to Day 1,821. All changes in participant vital signs were monitored on each day of study drug administration prior to dosing and 60 minutes after dosing.

Vital signs included body temperature, heart rate, and seated blood pressure. Clinically significant changes were defined as those that were not within the normal range for the participant.

Number of Participants Experiencing AEs of Special Interest in the OL Period
Day 365 to Day 2,185

AEs were defined as 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 have been identified to be those which may be associated with the use of immunomodulatory agents or infusion of therapeutic proteins. Acute infusional AEs were defined as those that occurred within 1 hour after the start of the infusion.

Mean BL Hematocrit in the OL Period
Baseline (Day 0), Day 365, Day 729, Day 1,093, Day 1,457, Day 1,821, Day 1,905, Day 1,989, Day 2,073, Day 2,185

Mean baseline values are those that are reported for each cohort at each time point on Day 365 to Day 2,185.

Mean Change From BL in Participant Hematocrit in the OL Period
BL (Day 0), Day 365, Day 729, Day 1,093, Day 1,457, Day 1,821, Day 1,905, Day 1,989, Day 2,073, Day 2,185

All changes in participant laboratory parameters were monitored on each day of study drug administration.

Mean BL Platelet Count in the OL Period
BL (Day 0), Day 365, Day 729, Day 1,093, Day 1,457, Day 1,821, Day 1,905, Day 1,989, Day 2,073, Day 2,185

Mean baseline values are those that are reported for each cohort at each time point on Day 365 to Day 2,185.

Mean Change From BL in Participant Platelet Count in the OL Period
BL (Day 0), Day 365, Day 729, Day 1,093, Day 1,457, Day 1,821, Day 1,905, Day 1,989, Day 2,073, Day 2,185

All changes in participant laboratory parameters were monitored on each day of study drug administration.

Mean BL Hemoglobin, Total Protein, and Albumin in the OL Period
BL (Day 0), Day 365, Day 729, Day 1,093, Day 1,457, Day 1,821, Day 1,905, Day 1,989, Day 2,073, Day 2,185

Mean baseline values are those that are reported for each cohort at each time point on Day 365 to Day 2,185.

Mean Change From BL in Hemoglobin, Total Protein, and Albumin in the OL Period
BL (Day 0), Day 365, Day 729, Day 1,093, Day 1,457, Day 1,821, Day 1,905, Day 1,989, Day 2,073, Day 2,185

All changes in participant laboratory parameters were monitored on each day of study drug administration.

Mean BL White Blood Cells in the OL Period
BL (Day 0), Day 365, Day 729, Day 1,093, Day 1,457, Day 1,821, Day 1,905, Day 1,989, Day 2,073, Day 2,185

Mean baseline values are those that are reported for each cohort at each time point on Day 365 to Day 2,185.

Mean Change From BL in White Blood Cells in the OL Period
BL (Day 0), Day 365, Day 729, Day 1,093, Day 1,457, Day 1,821, Day 1,905, Day 1,989, Day 2,073, Day 2,185

All changes in participant laboratory parameters were monitored on each day of study drug administration.

Mean BL Liver Function Parameters in the OL Period
BL (Day 0), Day 365, Day 729, Day 1,093, Day 1,457, Day 1,821, Day 1,905, Day 1,989, Day 2,073, Day 2,185

Mean baseline values are those that are reported for each cohort at each time point on Day 365 to Day 2,185.

Mean Change From BL in Liver Function Parameters in the OL Period
BL (Day 0), Day 365, Day 729, Day 1,093, Day 1,457, Day 1,821, Day 1,905, Day 1,989, Day 2,073, Day 2,185

All changes in participant laboratory parameters were monitored on each day of study drug administration.

Mean BL Select Laboratory Parameters in the OL Period
BL (Day 0), Day 365, Day 729, Day 1,093, Day 1,457, Day 1,821, Day 1,905, Day 1,989, Day 2,073, Day 2,185

Mean baseline values are those that are reported for each cohort at each time point on Day 365 to Day 2,185.

Mean Change From BL in Select Laboratory Parameters in the OL Period
BL (Day 0), Day 365, Day 729, Day 1,093, Day 1,457, Day 1,821, Day 1,905, Day 1,989, Day 2,073, Day 2,185

All changes in participant laboratory parameters were monitored on each day of study drug administration.

Mean BL Serum Electrolytes in the OL Period
BL (Day 0), Day 365, Day 729, Day 1,093, Day 1,457, Day 1,821, Day 1,905, Day 1,989, Day 2,073, Day 2,185

Mean baseline values are those that are reported for each cohort at each time point on Day 365 to Day 2,185.

Mean Change From BL in Serum Electrolytes in the OL Period
BL (Day 0), Day 365, Day 729, Day 1,093, Day 1,457, Day 1,821, Day 1,905, Day 1,989, Day 2,073, Day 2,185

All changes in participant laboratory parameters were monitored on each day of study drug administration.

Double-blind Period (DB); Number of Participants With American College of Rheumatology (ACR) 20 Response at Day 169
Day 169

ACR 20 response requires a participant to have a 20% reduction in the number of swollen and tender joints, and a reduction of 20% in three of the following five parameters: physician global assessment of disease, participant global assessment of disease, participant assessment of pain, C-reactive protein or erythrocyte sedimentation rate, and degree of disability in Health Assessment Questionnaire (HAQ) score. A participant achieved a sustained ACR 20 response if the participant had ACR 20 observed for at least 2 consecutive study visits.

DB; Number of Participants Achieving Clinically Meaningful Improvement in Health Assessment Questionnaire (HAQ)
Day 169

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.

Open-Label Period (OL); Number of Participants With Death, Serious Adverse Events (SAEs), Related SAEs, SAEs Leading to Discontinuation, AEs, Related AEs, or AEs Leading to Discontinuation
From first day of OL to 5.5 years

AE=any new untoward medical occurrence or worsening of a pre-existing medical condition which does not necessarily have a causal relationship with treatment. SAE=any untoward medical occurrence that at any dose: results in death, is life-threatening, requires inpatient hospitalization or causes prolongation of existing hospitalization, results in persistent or significant disability/incapacity, is a congenital anomaly/birth defect, results in development of drug dependency or drug abuse, is an important medical event.Related AE/SAE=Certain,Probable,Possible,or Missing relationship to Drug

OL; Number of Participants AEs of Special Interest
From first day of OL to 5.5 years

AE=any new untoward medical occurrence or worsening of a pre-existing medical condition which does not necessarily have a causal relationship with this treatment. AEs of special interest are those AEs that may be associated with the use of immunomodulatory drugs, including all infections, serious infections, and opportunistic infections; autoimmune disorders; neoplasms; acute infusional AEs (pre-specified AEs occurring within 1 hour of start of infusion) and peri-infusional AEs (pre-specified AEs occurring within 24 hours of the start of infusion).

OL; Number of Participants With Hematology Laboratories Meeting Marked Abnormality Criteria
From first day of OL to 5.5 years

Upper Normal Limit (ULN), Lower Normal Limit (LLN), Baseline (BL). Marked abnormality criteria are: Hemoglobin (HGB): \>3 g/dL decrease from BL; Hematocrit: \<0.75 \* BL; Erythrocytes: \<0.75 \* BL; Platelets (PLT): \<0.67 \* LLN/\>1.5 \* ULN, or if BL \< LLN then use 0.5 \* BL/\<100,000 mm\^3; Leukocytes: \<0.75 \* LLN/ \>1.25 \* ULN, or if BL\<LLN then use \<0.8 \* BL/\>ULN, or if BL\>ULN then use \>1.2 \* BL/\<LLN; neutrophils+bands: \<1.0 \* 10\^3 c/uL; eosinophils: \>0.750 \* 10\^3 c/uL; basophils: \> 400 mm\^3; monocytes: \>2000 mm\^3; lymphocytes: \<0.750 \* 10\^3 c/uL/ \>7.50 \* 10\^3 c/uL.

OL; Number of Participants With Blood Chemistry Laboratories Meeting Marked Abnormality Criteria
From first day of OL to 5.5 years

Marked abnormality criteria: Alkaline phosphatase (ALP): \>2\* ULN, or if BL\>ULN then use \>3\* BL; aspartate aminotransferase (AST): \>3\* ULN, or if BL\>ULN then use \>4\* BL; alanine aminotransferase (ALT): \>3\* ULN, or if BL\>ULN then use \>4\* BL; G-Glutamyl transferase (GGT): \>2\* ULN, or if BL\>ULN then use \>3\* BL; Bilirubin: \>2\* ULN, or if BL\>ULN then use \>4\* BL; blood urea nitrogen (BUN): \>2\* BL; creatinine: \>1.5\* BL

OL; Mean Time-matched Baseline Immunoglobulin (Ig) Levels Over the OL
Baseline and Days 169, 365, 729, and 1093

Serum samples collected from participants were used to determine serum levels of IgA, IgM, and IgG. Time-matched baseline values were presented by visit and represented the mean baseline value for only that cohort of participants with serum samples available at that visit.

OL; Mean Time-matched Change From Baseline in Immunoglobulin (Ig) Levels Over the OL
BL, Days 169, 365, 729, and 1093

Serum samples collected from participants were used to determine serum levels of IgA, IgM, and IgG. Time-matched mean change from baseline = Post-baseline value - time-matched baseline value, where the time-matched baseline value represents the mean baseline value for only that cohort of participants with serum samples available at that visit.

Double Blind Period (DB); Number of Participants With Death, Serious Adverse Events (SAEs), Related SAEs, SAEs Leading to Discontinuation, Adverse Events (AEs), Related AEs, or AEs Leading to Discontinuation
Day 1 to Day 365, and including data up to 56 days post last dose of double-blind medication

AE=any new untoward medical occurrence or worsening of a pre-existing medical condition which does not necessarily have a causal relationship with this treatment. SAE=any untoward medical occurrence that at any dose: results in death, is life-threatening, requires inpatient hospitalization or causes prolongation of existing hospitalization, results in persistent or significant disability/incapacity, is a congenital anomaly/birth defect, results in development of drug dependency or drug abuse, is an important medical event. Related SAE/AE = possibly, probably, or certainly related to study drug

DB; Number of Participants With AEs of Special Interest
Day 1 to Day 365, and including data up to 56 days post last dose of double-blind medication

AE=any new untoward medical occurrence or worsening of a pre-existing medical condition which does not necessarily have a causal relationship with this treatment. AEs of special interest are those AEs that may be associated with the use of immunomodulatory drugs, including all infections, serious infections, and opportunistic infections; autoimmune disorders; neoplasms; acute infusional AEs (pre-specified AEs occurring within 1 hour of start of infusion) and peri-infusional AEs (pre-specified AEs occurring within 24 hours of the start of infusion).

DB; Number of Participants With Hematology Laboratories Meeting Marked Abnormality Criteria
Day 1 to Day 365, and including data up to 56 days post last dose of double-blind medication

Upper Normal Limit (ULN), Lower Normal Limit (LLN), Baseline (BL). Marked abnormality criteria are: Hemoglobin (HGB): \>3 g/dL decrease from BL; Hematocrit: \<0.75 \* BL; Erythrocytes: \<0.75 \* BL; Platelets (PLT): \<0.67 \* LLN/\>1.5 \* ULN, or if BL \< LLN then use \<0.5 \* BL and \<100,000 mm\^3; Leukocytes: \<0.75 \* LLN/ \>1.25 \* ULN, or if BL\<LLN then use \<0.8 \* BL or \>ULN, or if BL\>ULN then use \>1.2 \* BL or \<LLN; neutrophils+bands: \<1.0 \* 10\^3 c/uL; eosinophils: \>0.750 \* 10\^3 c/uL; basophils: \> 400 mm\^3; monocytes: \>2000 mm\^3; lymphocytes: \<0.750 \* 10\^3 c/uL/ \>7.50 \* 10\^3 c/uL.

DB; Number of Participants With Blood Chemistry Laboratories Meeting Marked Abnormality (MA) Criteria
Day 1 to Day 365, and including data up to 56 days post last dose of double-blind medication

ULN=upper level of normal; BL=baseline.Marked abnormality criteria: High alkaline phosphatase (ALP): \>2\* ULN, or if BL\>ULN then use \>3\* BL; high aspartate aminotransferase (AST): \>3\* ULN (80 U/L), or if BL\>ULN then use \>4\* BL; high alanine aminotransferase (ALT): \>3\* ULN (34-47 U/L), or if BL\>ULN then use \>4\* BL; high G-Glutamyl transferase (GGT): \>2\* ULN, or if BL\>ULN then use \>3\* BL; high bilirubin: \>2\* ULN, or if BL\>ULN then use \>4\* BL; high blood urea nitrogen (BUN): \>2\* BL; high creatinine: \>1.5\* BL (ULN 14.6 pg/mg. AST ULN=80 U/L; ALT ULN=34-47 U/L;creatinine ULN=14.6 pg/mg.

DB; Number of Participants With Clinically Significant Physical Examination or Vital Signs Abnormalities
Days 1, 15, 29, 57, 85, 113, 141, 169, 197, 225, 253, 281, 309, 337. Vital signs were measured at these visits before and after study medication infusion.

Physical examinations were performed at the discretion of the investigator and included breast examinations for female participants. Vital sign measurements were performed for participants before and after infusion of study medication at each visit and included seated systolic blood pressure, seated diastolic blood pressure, temperature, and heart rate. Abnormalities were determined to be clinically significant by the investigator.

Open Label Period (OL); Number of Participants With Death, Serious Adverse Events (SAEs), Related SAEs, SAEs Leading to Discontinuation, Adverse Events (AEs), Related AEs, or AEs Leading to Discontinuation
Day 365 to Day 1,821

AE=any new untoward medical occurrence or worsening of a pre-existing medical condition which does not necessarily have a causal relationship with this treatment. SAE=any untoward medical occurrence that at any dose: results in death, is life-threatening, requires inpatient hospitalization or causes prolongation of existing hospitalization, results in persistent or significant disability/incapacity, is a congenital anomaly/birth defect, results in development of drug dependency or drug abuse, is an important medical event. Related SAE/AE = possibly, probably, or certainly related to study drug

OL; Number of Participants With Liver Function Laboratories Meeting Marked Abnormality Criteria
Day 365 to Day 1821, and including data up to 56 days post last dose of double-blind medication

Marked abnormality criteria: Alkaline phosphatase (ALP): \>2\* ULN, or if BL\>ULN then use \>3\* BL; aspartate aminotransferase (AST): \>3\* ULN, or if BL\>ULN then use \>4\* BL; alanine aminotransferase (ALT): \>3\* ULN, or if BL\>ULN then use \>4\* BL; G-Glutamyl transferase (GGT): \>2\* ULN, or if BL\>ULN then use \>3\* BL; Bilirubin: \>2\* ULN, or if BL\>ULN then use \>4\* BL; blood urea nitrogen (BUN): \>2\* BL; creatinine: \>1.5\* BL

OL; Number of Participants With Electrolyte Laboratories Meeting Marked Abnormality Criteria
Day 365 to Day 1821, and including data up to 56 days post last dose of double-blind medication

Marked abnormality criteria: Sodium (Na): \<0.95\*LLN/ \>1.05\*ULN, or if BL\<LLN then use \<0.95\* BL or \>ULN, or if BL\>ULN then use\>1.05\* BL or \<LLN; potassium (K): \<0.9\* LLN/\>1.1\*ULN, or if BL\<LLN then use \<0.9\* BL or \>ULN, or if BL\>ULN then use\>1.1\* BL or \<LLN; (Cl): \<0.9\* LLN/\>1.1\* ULN, or if BL\<LLN then use \<0.9\* BL or \>ULN, or if BL\>ULN then use\>1.1\* BL or \<LLN; calcium (Ca): \<0.8\* LLN/\>1.2\* ULN, or if BL\<LLN then use \<0.75\* BL or \>ULN, or if BL\>ULN then use\>1.25\* BL or \<LLN; phosphorous (P): \<0.75\* LLN/ \>1.25\* ULN, or if BL\<LLN then use 0.67\* BL or \>ULN, or if BL\>ULN then use\>1.33\* BL or \<LLN

OL; Number of Participants With Other Chemistry and Urinalysis Laboratories Meeting Marked Abnormality Criteria
Day 365 to Day 1821, and including data up to 56 days post last dose of double-blind medication

MA criteria: serum glucose (Glu): \<65 mg/dL/\>220 mg/dL;fasting serum Glu: \<0.8\* LLN/\>1.5\*ULN,or if BL\<LLN then use 0.8\*BL or \>ULN,or if BL\>ULN then use \>2.0\*BL or \<LLN;total protein: \<0.9\*LLN/\>1.1\*ULN,or if BL\<LLN then use \<0.9\*BL or \>UNL,or if BL\>UNL then use \>1.1\*BL or \<LLN; albumin: \<0.9\*LLN,or if BL\<LLN then use \<0.75 BL;uric acid: \>1.5\*ULN,or if BL\>ULN then use \>2\*BL. Urinalysis (Urine protein,urine Glu,urine blood,leukocyte esterase,Red Blood Cells \[RBCs\], White Blood Cells \[WBCs\]):Use ≥2 when BL value missing or when pre-dose=0 or 0.5; use ≥3 when pre-dose=1, use ≥4 when pre-dose=2 or 3

OL; Number of Participants With Clinically Significant Physical Examination or Vital Signs Abnormalities
Days 365 to Day 1821

Physical examinations were performed at the discretion of the investigator and included breast examinations for female participants. Vital sign measurements were performed for participants before and after infusion of study medication at each visit and included seated systolic blood pressure, seated diastolic blood pressure, temperature, and heart rate. Abnormalities were determined to be clinically significant by the investigator.

Inhibition & progression of structural damage
6 months

Assess inhibition \& progression of structural damage in MTX inadequate responders with moderate to severe active RA on SC Abatacept plus MTX, utilizing eMRI and X-ray at baseline, eMRI at Week 12, and eMRI and X-ray final assessment at week 24.

Event-free survival
Up to 3 years

Event-free survival is a composite endpoint defined as rejection-free, severe GVHD-free survival. Events for this outcome include death, severe (grade II-IV) acute GVHD up to day 100, moderate to severe chronic GVHD up to 1 year, and/or graft rejection up to 1 year.

Percentage of Participants in Renal Response at Day 113
From first dose to 113 days following first dose of the indicated period (113 days for Double-Blind Period, 226 days for Open Label Period)

Renal Response is defined as the presence of all the following criteria: PROTEINURIA: Reduction of baseline urine protein/creatinine ratio (UPCR) of \>= 50% and to less than 3. RENAL FUNCTION: No worsening of baseline estimated glomerular filtration rate (eGFR) defined as within normal range if normal at baseline or ≥ 75% baseline value if below normal at baseline.

Proportion of Participants With at Least One Adverse Events (AEs) or Serious AEs (SAEs) in 1 Year
52 weeks

Safety is measured using AEs, including clinical significant changes in vital signs, laboratory test abnormalities and clinical tolerability of abatacept, and using serious AEs

Change From Baseline in the Modified Rodnan Skin Score (mRSS) to Month 12
Baseline and 52 weeks

The efficacy of treatment on skin fibrosis will be measured by changes from baseline to month 12 in mRSS, a measure of skin thickness. mRSS scores have a range from 0 to 51, with higher score indicating greater severity of SSc (worse outcome).

Adverse Events
2 years

number of participants with adverse events

Percentage of Participants With an American College of Rheumatology (ACR) 20 Response at Day 169 in Short Term Period
Day 169

The ACR score of 20 indicates the degree of improvement in a patient's rheumatoid arthritis (RA), based on ACR guidelines (ACR20). The ACR score represents a percentage. To qualify for an ACR20 score, the patient must have \>=20% fewer tender joints and \>=20% fewer swollen joints and show 20% improvement in at least 3 of: patient overall assessment of his/her RA, physician global assessment of the patient's RA, patient self-assessment of pain, patient self-assessment of physical functioning, and results of an erythrocyte sedimentation rate or C-reactive protein test (to assess inflammation). Percentage is calculated n/N with n=number of participants with ACR score of 20 and N= all randomized participants who received at least one dose of study drug.

Percentage of Participants With Sustained American College of Rheumatology (ACR) Response at Day 533 in Long Term Period - All Randomized and Treated Participants During the Long Term Period
Day 533

The ACR score indicates the degree of improvement in a patient's rheumatoid arthritis (RA), based on ACR guidelines. The ACR score= a percentage. To qualify for a score of 20, 50 or 70 (ACR20, ACR50 or ACR70), the patient must have \>=20%, \>=50% or \>=70%, respectively, fewer tender joints and \>=20%, \>=50% or \>=70%, respectively, fewer swollen joints and show 20%, 50% or 70%, respectively, improvement in at least 3 of the following: patient overall assessment of his/her RA, physician global assessment of the patient's RA, patient self-assessment of pain, patient self-assessment of physical functioning, and results of an erythrocyte sedimentation rate or C-reactive protein test (to assess inflammation). Treatment groups represent treatment received in the short term period. Percentage calculated as n/m with n=number of paticipants with sustained ACR response at Day 533; m= long term participants who received at least one dose of drug and were ACR responders in the short term period.

Mean Change From Baseline in HAQ-DI Score at Day 533 in Long Term Period
Baseline to Day 533

Adjusted mean. The Health Assessment Questionnaire Disability Index (HAQ-DI) assesses patients' functional ability by rating their abilities over the previous week. At least 2 questions are asked from each of 8 categories: dressing and grooming, hygiene, arising, reach, eating, grip, walking, and common daily activities. Patients rate difficulty performing specific tasks: 0=without difficulty, 1=with some difficulty, 2=with much difficulty, and 3=unable to do. The sum of the categories score (the highest scored item in the category) is divided by the number of categories answered, yielding a score from 0-3. Treatment groups represent treatment received in the short term period. Baseline is Day 1 of the study or last non-missing pre-treatment value.

Percentage of Participants With Health Assessment Questionnaire (HAQ) Response at Day 533 in Long Term Period
Day 533

The Health Assessment Questionnaire (HAQ) disability index assesses patients' functional ability by rating their abilities over the previous week. At least 2 questions are asked from each of 8 categories: dressing and grooming, hygiene, arising, reach, eating, grip, walking, and common daily activities. Patients rate difficulty performing specific tasks: 0=without difficulty, 1=with some difficulty, 2=with much difficulty, and 3=unable to do. The higher the number the worse the outcome. The sum of the categories score (the highest scored item in the category) is divided by the number of categories answered, yielding a score from 0-3. HAQ response=reduction of at least 0.30 units in HAQ score from baseline. The percentage of participants with a reduction of at least 0.30 units in their HAQ score from baseline is presented. Baseline is Day 1 of the study or last non-missing pre-treatment value. Treatment groups represent treatment received in the short term period.

Mean Change in DAS28-CRP From Baseline at Day 533 in Long Term Period
Baseline to Day 533

The Disease Activity Score 28 using C-Reactive Protein (DAS28-CRP) is a measure of disease activity in rheumatoid arthritis (RA) and assesses the 28 joints RA commonly affects; the score includes the number of tender and swollen joints (out of 28), CRP level (a measure of inflammation in the blood), and the patient's global assessment of health (ranging from very good to very bad). An overall DAS \>5.1 implies active disease; \<3.2, well controlled disease; and \<2.6, remission.). Treatment groups represent treatment received in the short term period. Baseline is Day 1 of the study or last non-missing pre-treatment value.

Efficacy will be evaluated using the American College of Rheumatology response rate or ACR 20. This means the respective proportion of patients reaching an improvement of at least 20% of the ACR composite index from baseline.
at 6 months
Double Blind Period (DB); Number of Participants Experiencing a New SLE Flare
From start of corticosteroid taper to Day 365

SLE flares scored using BILAG:A:presence of =\>1 serious;B:more moderate;C:mild symptomatic;D:prior activity,no current symptoms;E:organ that has never been involved. Calculated based on change during previous 4 weeks (1=improving,2=staying same,3=worsening,4=new).New SLE flare:first BILAG 'A' or 'B' event adjudicated to be flare following resolution of entry flare and start of prednisone/prednisone-equivalent taper.Inception treatment failure included (entry flare did not subside by Day 57/participant discontinued double-blind period before Day 29).

Open Label Period (OL); Number of Participants Who Died, Experienced Adverse Events (AEs), Serious AEs, Drug Related AEs or SAEs and Discontinued Due to AEs
From start of study drug therapy in open-label period (Day 365) up to 56 days after the last dose of open-label period

AEs: any new untoward medical occurrences/worsening of pre-existing medical condition, whether or not related to study drug. SAE: any AE that resulted in death; was life threatening; resulted in persistent/significant disability/incapacity; resulted in/prolonged an existing in-patient hospitalization; was a congenital anomaly/birth defect; or was an overdose. Participants who discontinued the study due to an AE were recorded. Drug-related AEs or SAEs: events with a relationship to the study therapy of certain; probable; possible; or missing.

OL; Number of Participants With Significant AEs of Special Interest
From start of study drug therapy in open-label period (Day 365) up to 56 days after the last dose of open-label period

An AE was defined as any new untoward medical occurrence or worsening of a pre-existing medical condition (even if not caused by the study drug). For this study, it was decided that AEs of particular importance were associated with the use of immunomodulatory agents. Number of participants with infections, malignant Neoplasms, pre-specified autoimmune disorders, acute-infusional AEs and peri-infusional AEs were recorded.

OL; Number of Participants With Marked Abnormalities (MAs) in Hematology: Hemoglobin, Hematocrit, Erythrocytes and Platelet Count
From start of study drug therapy in open-label period (Day 365) up to 56 days after the last dose of open-label period

MAs are laboratory measurements marked as abnormal, per pre-defined study criteria, at any study time point. The following hematology MA definitions specify the criteria for the data presented. Hemoglobin: \>3 g/dL decrease from pre-treatment (pre-Rx) value; hematocrit: \<0.75\* pre-Rx value; erythrocyte count: \<0.75\* pre-Rx value; platelet count: \<0.67\* lower limit of normal (LLN) or \>1.5\* upper limit of normal (ULN) (or, if pre-Rx value \<LLN, then \<0.5\* pre-Rx value or \<100000/mm\^3).

OL; Number of Participants With MAs in Hematology: Leukocytes, Neutrophils + Bands (Absolute), Lymphocytes (Absolute), Monocytes (Absolute), Basophils (Absolute) and Eosinophils (Absolute)
From start of study drug therapy in open-label period (Day 365) up to 56 days after the last dose of open-label period

MMAs are laboratory measurements marked as abnormal, per pre-defined study criteria, at any study time point. The following hematology MA definitions specify the criteria for the data presented. Leukocytes: \<0.75\* LLN or \>1.25\* ULN (or, if pre-Rx value \<LLN, then \<0.8\* pre-Rx or \>ULN. If pre-Rx value \>ULN, then \>1.2\* pre-Rx or \<LLN; Neutrophils+bands (absolute): \<1.00\* 10\^3 cells/microliter (c/uL); Lymphocytes (absolute): \<0.75\* 10\^3 c/uL or \>7.50\* 10\^3 c/uL; Monocytes (absolute): \>2000/mm\^3; Basophils (absolute): \>0.40\* 10\^3 c/uL; Eosinophils (absolute): \>0.75\* 10\^3 c/uL.

OL; Number of Participants With MAs in Serum Chemistry: Alkaline Phosphatase (ALP), Aspartate-aminotransferase (AST), Alanine-aminotransferase (ALT), Gamma-glutamyl Transferase (GGT), Bilirubin(Total), Blood Urea Nitrogen (BUN), Creatinine
From start of study drug therapy in open-label period (Day 365) up to 56 days after the last dose of open-label period

MAs are laboratory measurements marked as abnormal, per pre-defined study criteria, at any study time point. The following serum chemistry MA definitions specify MA criteria. ALP, GGT: \>2\* ULN (if pre-Rx \>ULN, then \>3\* pre-Rx); AST, ALT: \>3\* ULN (if pre-Rx \>ULN, then \>4\* pre-Rx). Bilirubin (total): \>2\* ULN (if pre-Rx \>ULN, then \>4\* pre-Rx), BUN:\>2\* pre-Rx; Creatinine:\>1.5\* pre-Rx.

OL; Number of Participants With MAs in Serum Chemistry: Sodium (Serum), Potassium (Serum), Chloride (Serum), Calcium (Total), Protein (Total)
From start of study drug therapy in open-label period (Day 365) up to 56 days after the last dose of open-label period

MAs are laboratory measurements marked as abnormal, per pre-defined study criteria, at any study time point. The following serum chemistry MA definitions specify MA criteria, Sodium (serum): \<0.95x LLN or \>1.05x ULN (if pre-Rx\<LLN, then \<0.95x pre-Rx or \>ULN. If pre-Rx \>ULN, then \>1.05x pre-Rx or \<LLN); Potassium (serum), Chloride (serum), protein (total): \<0.9x LLN or \>1.1xULN (if pre-Rx \<LLN, then \<0.9xpre-Rx or \>ULN. If pre-Rx \>ULN, then \>1.1xpre-Rx or \<LLN; Calcium (total): \<0.8xLLN or \>1.2xULN (if pre-Rx \<LLN, then \<0.75x pre-Rx or \>ULN. If pre-Rx \>ULN, then \>1.25x pre-Rx or \<LLN.

OL; Number of Participants With MAs in Serum Chemistry: Glucose (Serum), Glucose (Fasting Serum), Albumin, Cholesterol (Total), Triglycerides, Fasting Triglycerides
From start of study drug therapy in open-label period (Day 365) up to 56 days after the last dose of open-label period

MAs are laboratory measurements marked as abnormal, as per pre-defined study criteria, at any study time point. The following serum chemistry MA definitions specify MA criteria, Glucose: \<65 mg/dL or \>220 mg/dL; Glucose (fasting serum): \<0.8\* LLN or \>1.5 ULN (if pre-Rx \<LLN, then \<0.8\* pre-Rx or \>ULN. If pre-Rx \>ULN, then \>2.0\* pre-Rx or \<LLN; Albumin: \<0.9\* LLN (if pre-Rx \<LLN, then \<0.75 \* pre-Rx); cholesterol (total): \>2\* pre-Rx; triglycerides: \>=2.5\* ULN, or if pre Rx\>ULN then use \>2.5\* pre Rx; fasting triglycerides: \>=2.0\* ULN, or if pre Rx\>ULN then use \>2.0\* pre Rx.

OL; Number of Participants With MAs in Urinalysis
From start of study drug therapy in open-label period (Day 365) up to 56 days after the last dose of open-label period

MAs are laboratory measurements marked as abnormal, per pre-defined study criteria, at any study time point. The following definitions specify the criteria for MAs in urinalysis, Protein, glucose, blood, Leukocyte esterase, red blood cells (RBC), white blood cells (WBC): \>=2+ (or, if value \>=4, or if pre-Rx value = 0 or 0.5, then \>= 2\* or if pre-Rx value =1, then \>=3, or if pre-Rx = 2 or 3, then \>=4); protein (24 hour urine): \>1000 mg/24 hrs and \>=2\* pre-Rx; Glomerular filtration rate (GFR): \<=60 mL/min/1.73m\^2 or \> 15% change from baseline; Protein/creatinine ratio: \> 100 mg/mmol.

Number of Participants With a Diagnosis of Rheumatoid Arthritis (RA) by American Rheumatism Association (ARA) Criteria and/or Discontinued Due to Lack of Efficacy
12 months

ARA criteria is a 7-item tool for RA classification purposes; a patient is said to have RA (meeting endpoint) if he or she has satisfied at least 4 of the 7 criteria. If a participant discontinued due to lack of efficacy, he/she was regarded as meeting primary endpoint also.

Number of Responders to American College of Rheumatology 20% Improvement Criteria (ACR 20) at Day 180 of the Double-Blind (DB) Period
Day 180

ACR 20 response requires a participant to have a 20% reduction in the number of swollen and tender joints, and a reduction of 20% in three of the following five parameters: physician global assessment of disease, participant global assessment of disease, participant assessment of pain, C-reactive protein or erythrocyte sedimentation rate, and degree of disability in Health Assessment Questionnaire score. A participant achieved a sustained ACR 20 response if the participant had ACR 20 observed for at least 2 consecutive study visits.

Participants Receiving Concomitant Disease Modifying Rheumatic Drugs and Biologics in Open-Label (OL) Period
Day 360 to Day 3,060

The number of participants receiving concomitant rheumatoid arthritis treatment with disease modifying rheumatic drugs and/or biologics.

Number of Participants Experiencing Adverse Events (AEs) and Serious Adverse Events (SAEs) in OL Period
Day 360 to Day 3060

AE=any new untoward medical occurrence or worsening of a pre-existing medical condition which does not necessarily have a causal relationship with treatment.SAE=any untoward medical occurrence that at any dose: results in death, is life-threatening, requires inpatient hospitalization or causes prolongation of existing hospitalization, results in persistent or significant disability/incapacity, is a congenital anomaly/birth defect, results in development of drug dependency or drug abuse, is an important medical event. Related AE/SAE=Certain,Probable,Possible,or Missing relationship to drug.

Number of Participants With AEs of Special Interest in OL Period
Day 360 to Day 3060

AEs were defined as 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 were those which may be associated with the use of immunomodulatory agents or infusion of therapeutic proteins. Acute infusional AEs were defined as those that occurred within 1 hour after the start of the infusion. Peri-Infusional AEs were defined as those that occurred within 24 hours after the start of the infusion.

Baseline Serum Immunoglobulin A (IgA) Over Time in OL Period
Baseline (Day 0) and Days 360, 720,1080, 1440, and 1800

Time-matched baseline (Day 0) values and post-baseline values were presented for each post-baseline visit and represent only that cohort of participants with measurements available at that post-baseline assessment. Mean Change from Baseline data for these cohorts are presented in Outcome Measure 6.

Mean Change From Baseline (BL) in IgA Over Time in OL Period
Baseline (Day 0) and Days 360, 720, 1080, 1440, and 1800

Blood samples for immunoglobulin assessments were obtained to determine change from baseline in serum IgA. Baseline data for these time-matched cohorts are presented in Outcome Measure 5.

Baseline Immunoglobulin G (IgG) Over Time in OL Period
Baseline (Day 0) and Days 360, 720, 1080, 1440 and 1800

Time-matched baseline (Day 0) values and post-baseline vales were presented for each post-baseline visit and represent only that cohort of participants with measurements available at that post-baseline assessment. Mean Change from Baseline data for these cohorts are presented in Outcome Measure 8.

Mean Change From Baseline (BL) in IgG Over Time in OL Period
Baseline (Day 0) and Days 360, 720, 1080, 1440, and 1800

Blood samples for immunoglobulin assessments were obtained to determine change from baseline in serum IgG. Baseline data for these cohorts are presented in Outcome Measure 7.

Baseline Immunoglobulin M (IgM) Over Time in OL Period
Baseline (Day 0) and Days 360, 720,1080,1440, and 1800

Time-matched baseline (Day 0) values and post-baseline values were presented for each post-baseline visit and represent only that cohort of participants with measurements available at that post-baseline assessment. Mean Change from Baseline data for these cohorts are presented in Outcome Measure 10.

Mean Change From Baseline (BL) in IgM in OL Period
Baseline (Day 0) and Days 360, 720, 1080, 1440, and 1800

Blood samples for immunoglobulin assessments were obtained to determine change from baseline in serum IgM. Baseline data for these time-matched cohorts are presented in Outcome Measure 9.

Number of Participants With Hematology Values Meeting Marked Abnormality Criteria in OL Period
Day 360 to Day 3060
Number of Participants With Liver and Kidney Function Values Meeting Marked Abnormality Criteria in OL Period
Day 360 to Day 3060
Number of Participants With Electrolyte Values Meeting Marked Abnormality Criteria in OL Period
Day 360 to Day 3060
Number of Participants With Glucose, Protein, Metabolites, and Urinalysis Values Meeting Marked Abnormality Criteria in OL Period
Day 360 to Day 3060
Abatacept combined with etanercept will have greater clinical efficacy compared to subjects receiving etanercept alone
at 6 months
Number of Participants With Adverse Events
baseline, 3 month and 6 months

Participants were monitored for adverse events (AEs) at each visit. Cumulative AEs were tracked including specific AE, severity, and relationship on source documentation. Special attention was given to infusion-related events and hypersensitivity reactions. Assessment of Complete Blood Count (CBC) and Metabolic profile were also tracked.

Maximum observed serum concentration (Cmax)
Up to Day 71
Area under the serum concentration-time curve from time zero to the last time of quantifiable concentration (AUC(0-T))
Up to Day 71
Area under the serum concentration-time curve from time zero extrapolated to infinity (AUC(INF))
Up to Day 71
Area Under the Curve AUC(INF)
From drug administration to 70 days following drug administration

Area under the serum concentration-time curve from time zero extrapolated to infinity

Adjusted Geometric Mean of Maximum Observed Serum Concentration (Cmax) of a Single Dose of Subcutaneous (SC) Abatacept - PK-Evaluable Analysis Population
Day 1 to Day 71

Serum concentrations of abatacept were analyzed using a validated enzyme-linked immunosorbent assay (ELISA). Cmax was measured in micrograms per milliliter (μg/mL). Blood samples for pharmacokinetic (PK) parameters were collected at Day 1 pre-dose at 0 hour (h), 1, 2, and 8 h post dose, and on subsequent Days, 2 (24 h post dose), 3 (48 h), 5 (96 h), 8 (168 h), 15 (336 h), 29 (672 h) , 43 (1008 h), 57 (1344 h) and 71 (1680 h) following the single administration of abatacept SC.

Adjusted Geometric Mean of Area Under the Serum Concentration-time Curve (AUC) From Zero to the Last Time of the Last Quantifiable Concentration (0-T) of a Single Dose of SC Abatacept - PK-Evaluable Analysis Population
Day 1 to Day 71

Serum concentrations of abatacept were analyzed using ELISA. AUC (0-T) was measured in μg\*h/mL. Blood samples were collected at Day 1 pre-dose at 0 h, 1, 2, and 8 h post dose, and on subsequent Days, 2 (24 h post dose), 3 (48 h), 5 (96 h), 8 (168 h), 15 (336 h), 29 (672 h) , 43 (1008 h), 57 (1344 h) and 71 (1680 h) following the single administration of abatacept SC.

Adjusted Geometric Mean of Area Under the Serum Concentration-time Curve From Time Zero to Extrapolated to Infinity, AUC (INF), of a Single Dose of SC Abatacept - PK-Evaluable Analysis Population
Day 1 to Day 71

Serum concentrations of abatacept were analyzed using ELISA. Blood samples were collected at Day 1 pre-dose at 0 hour (h), 1, 2, and 8 h post dose, and on subsequent Days, 2 (24 h post dose), 3 (48 h), 5 (96 h), 8 (168 h), 15 (336 h), 29 (672 h) , 43 (1008 h), 57 (1344 h) and 71 (1680 h) following the single administration of abatacept SC. AUC (INF) was measured in μg\*h/mL

Maximum Observed Concentration (Cmax) of Single Dose Abatacept - Pharmacokinetic Evaluable Population
Days 1 to 71

Cmax was derived from serum concentration versus time data. Serum samples were analyzed for abatacept by a validated enzyme-linked immunosorbent assay (ELISA) and were obtained at: predose (0 hours), 0.25 hours (h), 0.5, 1, 2, 6, 12, 24, 72, 168, 336, 504, 672, 1008, 1344, and 1688 h post dose (Days 1 to 71). The results were summarized. The lower limit of assay quantitation (LLOQ) was 1.00 nanograms per milliliter (ng/mL). Cmax was measured in micro grams per milliliter (µg/mL).

Time to Reach Maximum Concentration (Tmax) of Single Dose Abatacept - Pharmacokinetic Evaluable Population
Day 1 to Day 71

Tmax was derived from serum concentration versus time data. Serum samples were analyzed for abatacept by a validated enzyme-linked immunosorbent assay (ELISA) and were obtained at: predose (0 hours), 0.25 hours (h), 0.5, 1, 2, 6, 12, 24, 72, 168, 336, 504, 672, 1008, 1344, and 1688 h post dose (Days 1 to 71). The results were summarized. The lower limit of assay quantitation (LLOQ) was 1.00 nanograms per milliliter (ng/mL). Tmax was measured in hours (h).

Area Under the Concentration-time Curve (AUC) From Time Zero to 28 Days [AUC(0-28 Days)] of Single Dose Abatacept - Pharmacokinetic Evaluable Population
Day 1 to Day 71

AUC (0 - 28) was derived from serum concentration versus time data. Serum samples were analyzed for abatacept by a validated enzyme-linked immunosorbent assay (ELISA) and were obtained at: predose (0 hours), 0.25 hours (h), 0.5, 1, 2, 6, 12, 24, 72, 168, 336, 504, 672, 1008, 1344, and 1688 h post dose (Days 1 to 71). The results were summarized. The lower limit of assay quantitation (LLOQ) was 1.00 nanograms per milliliter (ng/mL). AUC (0 - 28) was measured in micro grams\*hours per milliliter (µg\*h/mL).

Area Under the Concentration-time Curve From Zero to the Last Time of the Last Quantifiable Concentration [AUC(0-T)] of Single Dose Abatacept - Pharmacokinetic Evaluable Population
Day 1 to Day 71

AUC (0 - T) was derived from serum concentration versus time data. Serum samples were analyzed for abatacept by a validated enzyme-linked immunosorbent assay (ELISA) and were obtained at: predose (0 hours), 0.25 hours (h), 0.5, 1, 2, 6, 12, 24, 72, 168, 336, 504, 672, 1008, 1344, and 1688 h post dose (Days 1 to 71). The results were summarized. The lower limit of assay quantitation (LLOQ) was 1.00 nanograms per milliliter (ng/mL). AUC (0 - T) was measured in micro grams\*hour per milliliter (µg\*h/mL).

Area Under the Concentration-time Curve From Time Zero Extrapolated to Infinity [AUC(0 - INF)] of Single Dose Abatacept - Pharmacokinetic Evaluable Population
Day 1 to Day 71

AUC (0 - INF) was derived from serum concentration versus time data. Serum samples were analyzed for abatacept by a validated enzyme-linked immunosorbent assay (ELISA) and were obtained at: predose (0 hours), 0.25 hours (h), 0.5, 1, 2, 6, 12, 24, 72, 168, 336, 504, 672, 1008, 1344, and 1688 h post dose (Days 1 to 71). The results were summarized. The lower limit of assay quantitation (LLOQ) was 1.00 nanograms per milliliter (ng/mL). AUC (0 - INF) was measured in µg\*h/mL.

Terminal Phase Elimination Half-life (T-HALF) of Single Dose Abatacept - Pharmacokinetic Evaluable Population
Day 1 to Day 71

T-HALF was derived from serum concentration versus time data. Serum samples were analyzed for abatacept by a validated enzyme-linked immunosorbent assay (ELISA) and were obtained at: predose (0 hours), 0.25 hours (h), 0.5, 1, 2, 6, 12, 24, 72, 168, 336, 504, 672, 1008, 1344, and 1688 h post dose (Days 1 to 71). The results were summarized. The lower limit of assay quantitation (LLOQ) was 1.00 nanograms per milliliter (ng/mL). T-HALF was measured in hours (h).

Total Body Clearance (CLT) of Single Dose Abatacept - Pharmacokinetic Evaluable Population
Day 1 to Day 71

CLT was the volume of abatacept cleared by the system, normalized by baseline body weight. Serum samples were analyzed for abatacept by a validated enzyme-linked immunosorbent assay (ELISA) and were obtained at: predose (0 hours), 0.25 hours (h), 0.5, 1, 2, 6, 12, 24, 72, 168, 336, 504, 672, 1008, 1344, and 1688 h post dose (Days 1 to 71). The results were summarized. The lower limit of assay quantitation (LLOQ) was 1.00 nanograms per milliliter (ng/mL). CLT was measured in milliliters per hours per kilogram of body weight (mL/h/kg).

Volume of Distribution at Steady-state (Vss) of Single Dose Abatacept - Pharmacokinetic Evaluable Population
Day 1 to Day 71

Vss was derived from serum concentration versus time data. Serum samples were analyzed for abatacept by a validated enzyme-linked immunosorbent assay (ELISA) and were obtained at: predose (0 hours), 0.25 hours (h), 0.5, 1, 2, 6, 12, 24, 72, 168, 336, 504, 672, 1008, 1344, and 1688 h post dose (Days 1 to 71). The results were summarized. The lower limit of assay quantitation (LLOQ) was 1.00 nanograms per milliliter (ng/mL). Vss was measured in liters per kg body weight (L/kg).

Short-term Period: Number of Participants With Adverse Events (AEs), Serious AEs (SAEs), Deaths, Discontinuations and Infusional AEs
From Day 1 of double-blind period to 1st dose of long-term 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. Related AE=relationship of certain, probable, possible, or missing. 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 the development of drug dependency or drug abuse, is an important medical event.

Short-term Period: Number of Adverse Events (AEs) Related to Study Drug
From Day 1 of double-blind period to 1st dose of long-term 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. Related AE=relationship of certain, probable, possible, or missing. Intensity = mild (grade 1), moderate (grade 2), severe (grade 3), life-threatening/disabling (grade 4).

Short-term Period: MeanSystolic and Diastolic Blood Pressure
Day 1 predose and postdose and Day 2

Vital sign measurements are summarized without regard to position (sitting, standing, supine).

Short-term Period: Mean Heart Rate
Day 1 predose and postdose and Day 2

Vital signs measurements are summarized without regard to position (sitting, standing, supine).

Short-term Period: Mean Respirations Rate
Day 1 predose and postdose and Day 2

Vital sign measurements are summarized without regard to position (sitting, standing, supine).

Short-term Period: Mean Temperature
Day 1 predose and postdose and Day 2

Vital sign measurements are summarized without regard to position (sitting, standing, supine).

Short-term Period: Number of Participants With Clinical Laboratory and Electrocardiogram (ECG) Abnormalities
Screening and Days 1 and 2

Laboratory tests consisted of complete blood count, chemistry, and urinalysis.

Short Term Period: Steady-state Trough Serum Concentration (Cmin) of Abatacept Following Weekly Subcutaneous Dosing in Participants With Active Rheumatoid Arthritis Receiving Disease Modifying Anti-rheumatic Drugs (DMARDS)
Days 71 to 85

Participants received abatacept while also receiving DMARDS over a short term (ST) 12 Week period. To eliminate contribution from the IV loading dose of abatacept during the short term study period, Cmin values were selected from Days 71 to 85, when contribution from IV was negligible. Minimum trough serum concentration of abatacept (Cmin) was measured in micrograms/milliliter (µg/mL). Data are presented by treatment the participant actually received, not by what they were randomized to receive.

Number of Participants With Adverse Events (AEs), Serious Adverse Events (SAEs), Deaths, Discontinuations Due to Adverse Events Reported During the Variable Dosing Phase of the Long Term Period (LTE)
Day 85 to 56 days post last dose

AEs during variable dose phase of LTE + 56 days post last dose in the variable dose phase or start of the fixed dose phase, which ever came first; includes deaths reported during the variable dose phase including those that occurred greater than 56 days after last dose. Medical Dictionary for Regulatory Activities (MedDRA) version: 15.1. AE=any new unfavorable symptom, sign, or disease or worsening of a preexisting condition that may not have a causal relationship with treatment. SAE=medical event that at any dose results in death, persistent or significant disability/incapacity, or drug dependency/abuse; is life-threatening, an important medical event, or a congenital anomaly/birth defect; or requires or prolongs hospitalization (included hospitalizations for elective surgical procedures). Treatment-related=having certain, probable, possible, or missing relationship to study drug. Data presented by treatment the participant was randomized to and not what they actually received.

Number of Participants With Pre-specified AEs of Special Interest in the Variable Dosing Phase of Long Term Extension (LTE)
Day 85 to Day 533

LTE period with variable abatacept dosing starting on Day 85 and continuing until Day 533 when LTE fixed dosing started. AEs of special interest: infection and/or infestation; neoplasms (malignant); pre-specified autoimmune disorder; infusional AEs (peri-infusional: pre-specified AEs occurring during first 24 hours (hrs) after start of the IV loading dose; acute infusional: pre-specified AEs occurring during the first hour after the start of the IV loading dose; systemic injection site reactions (SIR): pre-specified AEs for SIR; local injection site reaction: pre-specified AEs for local site reaction. Data are presented by treatment the participant was randomized to and not what they actually received.

Number of Participants With Adverse Events (AEs), Serious Adverse Events (SAEs), Deaths, Discontinuations Due to Adverse Events Summarized Over the Entire Long Term Extension (LTE) Period (Both Variable and Fixed Dosing)
Day 533 to 56 Days Post last dose

On Day 85 participants rolled over into the LTE with variable dose phase first and at Day 533, a fixed dose phase of 125 mg abatacept SC weekly, irrespective of body weight. This summary includes AEs reported during entire LTE treatment plus 56 days post last dose; includes all deaths reported during the LTE including those that occurred greater than 56 days after last dose. MedDRA version: 15.1. AE=any new unfavorable symptom, sign, or disease or worsening of a preexisting condition that may not have a causal relationship with treatment. SAE=a medical event that at any dose results in death, persistent or significant disability/incapacity, or drug dependency/abuse; is life-threatening, an important medical event, or a congenital anomaly/birth defect; or requires or prolongs hospitalization (also included hospitalizations for elective surgical procedures). Treatment-related=having certain, probable, possible, or missing relationship to study drug.

Comparison of each subject's synovial tissue markers
at baseline and after 4 months of treatment with abatacept
To test pharmacokinetics
Pharmacokinetics throughout study period
Until Day 43 or Day 120 depending on dose level
Change relative to pretreatment of the Overall Disease Severity Score (ODSS) for psoriasis vulgaris as assess by a blinded observer. Phage-Neutralizing anitbody titer
at Day 43
Secondary Endpoints
Percentage of SE+ Participants Achieving Disease Activity Score 28 Joint Count Calculated Using C Reactive Protein Remission (DAS28-CRP < 2.6) at Week 24
Week 24
Percentage of Participants Meeting 50% Improvement in American College of Rheumatology Criteria (ACR50) Response at Week 24
Baseline, week 24
Percentage of SE+ Participants Achieving Clinical Disease Activity Index Remission (CDAI <= 2.8) at Week 24
Week 24
Unlock Study Endpoints
Study Design & Arms
AllocationRANDOMIZED
MaskingSINGLE
ModelPARALLEL
PurposeTREATMENT
Treatment Arms
ArmTypeDescription
Arm 1: Abatacept + MethotrexateEXPERIMENTAL -
Arm 2: (Adalimumab + Methotrexate) followed by (Abatacept + Methotrexate)EXPERIMENTAL -
Abatacept subcutaneous + Standard TreatmentACTIVE_COMPARATORAbatacept subcutaneous weekly in addition to the subject's current standard treatment for 24 weeks followed by a 28 week open-label period of abatacept treatment plus the subject's current standard treatment.
Placebo of Abatacept subcutaneous + Standard TreatmentPLACEBO_COMPARATORPlacebo of Abatacept subcutaneous weekly in addition to the subject's current standard treatment for 24 weeks followed by a 28 week open-label period of abatacept treatment plus the subject's current standard treatment.
AbataceptEXPERIMENTALAbatacept for subcutaneous injection 125mg/mL in 1 mL pre-filled syringe for 6 months followed by Open-Label Abatacept for subcutaneous injection 125mg/mL in 1 mL pre-filled syringe for 6 months
PlaceboPLACEBO_COMPARATORPlacebo for Abatacept for subcutaneous injection 125mg/mL in 1 mL pre-filled syringe for 6 months followed by Open-Label Abatacept for subcutaneous injection 125mg/mL in 1 mL pre-filled syringe for 6 months
Combination Therapy: Abatacept + MethotrexateEXPERIMENTALAbatacept 125 mg subcutaneous injection once per week + Methotrexate at least 15mg per week tablet or capsule orally once per week
Methotrexate treatmentACTIVE_COMPARATORMethotrexate at least 15mg per week tablet or capsule orally
Abatacept PlaceboPLACEBO_COMPARATORPlacebo for Abatacept subcutaneous injection once per week
Methotrexate PlaceboPLACEBO_COMPARATORPlacebo to match Methotrexate capsule orally once per week
Blinded abataceptEXPERIMENTALParticipants will receive blinded abatacept 125 mg administered by subcutaneous injection once a week for at least 12 months. Subjects may be removed from treatment earlier due to a disease relapse, disease worsening, or if they have not achieved remission by treatment month 6.
blinded placeboPLACEBO_COMPARATORParticipants will receive blinded placebo. Placebo will be administered by subcutaneous injection once a week for at least 12 months. Subjects may be removed from treatment earlier due to a disease relapse, disease worsening, or if they have not achieved remission by treatment month 6.
Short and Long Terms: OrenciaEXPERIMENTALShort Term: Orencia 50 mg/mL, 87.5 mg/mL, 125 mg/mL pre-filled syringes subcutaneously (0.4 mL/0.7 mL/1.0 mL) weekly for 4 months Long term: Orencia 50 mg/mL, 87.5 mg/mL, 125 mg/mL pre-filled syringes subcutaneously (0.4 mL/0.7 mL/1.0 mL) weekly for 20 months
Abatacept (Autoinjector and Prefilled Syringe)EXPERIMENTALAbatacept (prefilled syringe) 125 mg/device solution subcutaneously weekly for 3 months Abatacept (autoinjector) 125 mg/device solution subcutaneously weekly for 1 month
Abatacept, 125 mg, plus methotrexate, 2.5 mgACTIVE_COMPARATORParticipants received abatacept, 125 mg subcutaneously, plus methotrexate, 2.5 mg orally as tablets, once weekly, during the 12-month Treatment Period
Methotrexate, 2.5 mg, plus abatacept placeboACTIVE_COMPARATORParticipants received methotrexate, 2.5 mg, orally as tablets, plus abatacept placebo subcutaneously, once weekly during the 12-month Treatment Period
Abatacept, 125 mg, plus methotrexate placeboACTIVE_COMPARATORParticipants received abatacept, 125 mg subcutaneously, plus methotrexate placebo tablets orally, once weekly during the 12-month Treatment Period
AdalimumabACTIVE_COMPARATOR -
Abatacept, 10 mg/kgEXPERIMENTAL -
1EXPERIMENTAL -
Subcutaneous (SC) AbataceptACTIVE_COMPARATORParticipants received 125 mg weekly SC abatacept injections (with an intravenous \[IV\] abatacept loading dose on Day 1, based on weight). A double-dummy design was used to protect the blind, thus, participants also received IV injections of placebo (IV Placebo) with the exception that on Day 1 a loading dose of IV abatacept replaced the IV Placebo treatment.
Intravenous (IV) AbataceptACTIVE_COMPARATORParticipants received IV abatacept infusions on Days 1, 15, 29, and every 28 days, thereafter. A double-dummy design was used to protect the blind, thus, participants also received SC injections of placebo (SC Placebo).
Subcutaneous (SC) Abatacept + Methotrexate (MTX) CohortEXPERIMENTALIn the ST period, participants were administered a dose of 125 mg abatacept SC, once weekly, for 4 months. Participants were also administered a stable MTX dose of greater than or equal to 10 mg once weekly for at least 4 weeks prior to first injection of SC abatacept.
SC Abatacept Monotherapy CohortEXPERIMENTALIn the ST period, participants were administered a dose of 125 mg abatacept SC, once weekly, for 4 months. Participants did not receive MTX at screening i.e., MTX naive, or discontinued MTX due to lack of efficacy or tolerability at least 4 weeks prior to first injection of SC abatacept.
Abatacept + Methotrexate (Double-blind period)ACTIVE_COMPARATOR -
Placebo + Methotrexate (Double-blind period)PLACEBO_COMPARATOR -
Abatacept and MethotrexateEXPERIMENTAL -
Placebo and MethotrexatePLACEBO_COMPARATOR(standard of care)
Abatacept - Open LabelEXPERIMENTALOpen-label extension phase
Abatacept (10 mg/Kg)ACTIVE_COMPARATOR -
Abatacept (5 mg/Kg)ACTIVE_COMPARATOR -
Arm 1: Participants from Phase I study (IM101-034)EXPERIMENTAL -
Arm 2: Participants from Phase II study (IM101-071)EXPERIMENTAL -
Arm 3: New Participants with Methotrexate (MTX) IntoleranceEXPERIMENTAL -
Abatacept (ABA)EXPERIMENTALInduction Period; 3 arms for Cohort 1: ABA 30/\~10 mg/kg (ABA administered at 30 mg/kg followed by ABA at \~10 mg/kg), ABA \~10 mg/kg, ABA 3 mg/kg Induction Period; 2 arms for Cohort 2: ABA 30/\~10 mg/kg and Second Cohort ABA \~10 mg/kg 1 arm for maintenance period (ABA \~10 mg/kg)
ABA + MTXACTIVE_COMPARATORabatacept 10 mg/kg intravenous (IV) + methotrexate
Placebo (PLA) + MTXACTIVE_COMPARATORplacebo IV + methotrexate
Open-label Abatacept (ABA)-Previous UserEXPERIMENTALIn participants who have had an inadequate efficacy response or intolerance on previous TNF-antagonist therapy (off therapy for at least 2 months), open-label abatacept was administered on Days 1, 15, and 29 and then once a month thereafter on a background of non-biologic Disease Modifying Anti-Rheumatic Drug (DMARD)s. Participants weighing \< 60 kg received 500 mg, participants weighing 60 to 100 kg received 750 mg, and participants weighing \> 100 kg received 1 gram of open-label abatacept by intravenous (IV) infusion.
Open-label ABA-Current UserEXPERIMENTALIn participants currently using Tumor Necrosis Factor (TNF)-agonists, open-label abatacept was administered on Days 1, 15, and 29 and then once a month thereafter on a background of non-biologic Disease Modifying Anti-Rheumatic Drug (DMARD)s. Participants weighing \< 60 kg received 500 mg, participants weighing 60 to 100 kg received 750 mg, and participants weighing \> 100 kg received 1 gram of open-label abatacept by intravenous (IV) infusion.
Long-term ABAEXPERIMENTALParticipants continued to receive the same 10 mg/kg weight-tiered dose of abatacept that they received in the initial short-term period.
Abatacept + MethotrexateEXPERIMENTALShort Term: Abatacept was dosed by weight with participants weighing \< 60 kg received abatacept 500 mg; participants ≥ 60 kg and ≤ 100 kg received abatacept 750 mg; and participants \> 100 kg received abatacept 1 g. Participants continued treatment with methotrexate (MTX) either orally or parenterally at a minimum dose of 15 mg.
Placebo + MethotrexateACTIVE_COMPARATORShort Term: Participants received a placebo solution intravenously and methotrexate at the dose employed prior to study enrollment and a minimum of 15 mg.
Abatacept + Methotrexate Open LabelEXPERIMENTALOpen Label: Abatacept was dosed intravenously by weight at 10 mg/kg in the OL period under tiered dosing such that participants weighing \< 60 kg received abatacept 500 mg; participants ≥ 60 kg and ≤ 100 kg received abatacept 750 mg; and participants \> 100 kg received abatacept 1 g. MTX was continued at the dose used in the DB period.
Abatacept (Long Term)ACTIVE_COMPARATORLong Term Portion of Study: All participants receive Active Drug
Double-blind abataceptACTIVE_COMPARATORParticipants received a fixed dose of abatacept approximating 10 mg/kg (500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 g for participants \> 100 kg). Abatacept was administered intravenously (IV) on Days 1, 15, 29, and every 28 days thereafter, for a total of 14 doses. Participants also received background therapy(ies) for rheumatoid arthritis (RA) (non-biologic or biologic disease-modifying drugs \[DMARDs\], or combination) throughout the double-blind treatment period
Double-blind PlaceboPLACEBO_COMPARATORParticipants received Placebo (dextrose 5% water \[D5W\] for injection U.S.P or normal saline \[NS\]) for IV infusion administered on Days 1, 15, 29, and every 28 days thereafter, for a total of 14 doses. Participants also received background therapy(ies) for rheumatoid arthritis (RA) (non-biologic or biologic disease-modifying drugs \[DMARDs\], or combination) throughout the double-blind treatment period.
Open-label AbataceptACTIVE_COMPARATORParticipants received abatacept (weight-tiered 10 mg/kg dose) IV every 28 days during the open-label period.
Open-Label Subcutaneous AbataceptEXPERIMENTALOpen-Label Subcutaneous Abatacept
Participants Receiving AbataceptEXPERIMENTALPediatric participants who are undergoing URD HSCT for serious NMHD will receive 8 doses of abatacept in addition to conventional GVHD prophylaxis.
open-label abatacept first, then 5 mg/kg abataceptEXPERIMENTAL10 mg/kg abatacept (6 months). Then 5 mg/kg abatacept (18 months)
open-label abatacept first, then 10 mg/kg abataceptEXPERIMENTAL10 mg/kg abatacept (6 months). Then 10 mg/kg abatacept (18 months)
Subcutaneous (SC) abatacept, 125 mgACTIVE_COMPARATOR -
Intravenous (IV) abatacept, 125 mgACTIVE_COMPARATOR -
Abatacept 2 mg/kgACTIVE_COMPARATOR -
Abatacept 10 mg/kgACTIVE_COMPARATOR -
Abatacept + PrednisoneACTIVE_COMPARATORDouble Blind Period
Placebo + PrednisonePLACEBO_COMPARATORDouble Blind Period
2PLACEBO_COMPARATOR -
Abatacept (10 mg/Kg) - Open LabelEXPERIMENTAL -
Abatacept (2 mg/kg) - Double blindEXPERIMENTAL -
Abatacept (10 mg/kg) - Double blindEXPERIMENTAL -
Placebo - Double blindEXPERIMENTAL -
Abatacept Treatment AEXPERIMENTAL -
Abatacept Treatment BEXPERIMENTAL -
Treatment AEXPERIMENTALParticipants will receive abatacept at a single dose of 750 mg as IV infusion on Day 1 converted from drug substance by a new process.
Treatment BACTIVE_COMPARATORParticipants will receive abatacept at a single dose 750 mg as IV infusion on Day 1 converted from drug substance by converted from drug substance by the current process.
Arm 1: Abatacept (autoinjector)EXPERIMENTALAbatacept 125 mg/syringe subcutaneously through autoinjector, one dose in 71 days
Arm 2: Abatacept (prefilled syringe)EXPERIMENTALAbatacept 125 mg/syringe subcutaneously with prefilled syringe, one dose in 71 days
Abatacept (BMS-188667) manufactured at Lonza, NH facilityACTIVE_COMPARATOR -
Abatacept (BMS-188667) manufactured at Devens, MA facilityEXPERIMENTAL -
Abatacept, 30 mg/kgACTIVE_COMPARATOR -
Group 1 (weight < 60 kg)PLACEBO_COMPARATOR -
Group 2 (weight < 60 kg)PLACEBO_COMPARATOR -
Group 3 (weight 60-100 kg)PLACEBO_COMPARATOR -
Group 4 (weight > 100 kg)PLACEBO_COMPARATOR -
Group 5 (weight > 100 kg)PLACEBO_COMPARATOR -
Interventions
NameTypeDescription
AbataceptDRUGAbatacept SC (125 mg) once weekly
AdalimumabDRUGAdalimumab SC (40 mg) once every 2 weeks
MethotrexateDRUGMethotrexate oral/parenteral maximum tolerated dose (minimum 15 mg and maximum 25 mg weekly)
Abatacept subcutaneousDRUGSpecified dose of Abatacept subcutaneous on specified days
PlaceboDRUGPlacebo of Abatacept subcutaneous
Abatacept PlaceboOTHER -
Methotrexate PlaceboOTHER -
Subcutaneous (SC) AbataceptDRUGParticipants received 125 mg weekly SC abatacept injections (with an intravenous \[IV\] abatacept loading dose on Day 1, based on weight). A double-dummy design was used to protect the blind, thus, participants also received IV injections of placebo (IV Placebo) with the exception that on Day 1 a loading dose of IV abatacept replaced the IV Placebo treatment.
Intravenous (IV) AbataceptDRUGParticipants received IV abatacept infusions on Days 1, 15, 29, and every 28 days, thereafter. A double-dummy design was used to protect the blind, thus, participants also received SC injections of placebo (SC Placebo). 500mg (for body weight up to 60 kg) 750 mg (body weight between 61 and 100 kg) 1g (body weight above 100 kg)infusions
Methotrexate (MTX)DRUGParticipants who were currently receiving methotrexate at a stable dose ≥ 10 mg for at least 4 weeks
abatacept (ABA)DRUGDextrose 5% in water, IV. Placebo on days IP-1, IP-15,IP-29, IP-57; 3 mg/kg on days IP-1, IP-15,IP-29, IP-57; 10 mg/kg on days IP-1, IP-15,IP-29, IP-57; or 30 mg/kg on days IP-1,IP-15 and \~10 mg/kg on days IP-29, IP-57 (ABA 30/\~10 mg/kg Group). Induction Period 3 months Maintenance Period 12 months
Non-biologic Disease Modifying Anti-Rheumatic Drug (DMARD)DRUGDuring the study, subjects continued to receive 1 or more background non-biologic DMARDs (e.g. methotrexate, leflunomide) at the dose level(s) and regimen(s) administered at the time of abatacept treatment onset (Day 1).
Anti-Tumor Necrosing Factor (TNF) TherapyDRUGAny of the anti-TNF therapies (Infliximab, Adalimumab, Etanercept, etc.)administered at the approved label dose for at least 3 months
Double-blind AbataceptDRUGConcentrate and diluted in a solution, IV, 500 mg (body weight \< 60 Kg); 750 mg (body weight 60-100 Kg); 1000 mg (body weight \> 100 Kg), Once daily, Day 1, 15, and 29.
Double-blind PlaceboDRUGConcentrate and diluted in a solution, IV, 0 mg, Once daily, Day 1, 15, and 29.
Open-label AbataceptDRUGConcentrate and diluted in a solution, IV, 500 mg (body weight \< 60 Kg); 750 mg (body weight 60-100 Kg); 1000 mg (body weight \> 100 Kg), Once daily, Every 28 days.
Subcutaneous AbataceptBIOLOGICALSubcutaneous Abatacept 125 mg once weekly for 6 months
Normal SalineOTHERNormal Saline administer on Day 1, 15, 29 and then every 28 days
D5WOTHERDextrose 5% in Water (D5W) administered on Day 1, 15, 29 and then every 28 days
PrednisoneDRUGTablets, oral, 30 mg, daily for 28 days then taper off, 12 months
Abatacept (BMS-188667)DRUGIV, 10 mg/Kg, monthly, for the duration of the trial
abatacept (Orencia ®)DRUG4 doses of abatacept administered intravenously at baseline, 2 weeks, 4 week, and 8 weeks.
Abatacept or Placebo (both as IV & SC Solution)DRUGAbatacept \& Placebo as IV \& SC solution, IV/SC, Abatacept 500 mg IV (Day 1)/Abatacept 75 mg SC (once weekly for 12 weeks) or Placebo IV(Day 1)/Placebo SC (once weekly for 12 weeks), 12 weeks then long term extension (LTE).
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Eligibility Criteria
Age Range18 Years to N/A
SexALL
Healthy VolunteersNo
Study Sites75

Inclusion Criteria: * Early rheumatoid arthritis (RA), defined as symptoms of RA that started ≤ 12 months prior to screening and satisfied the American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) 2010 criteria for the classification of RA at some point during the 12-month...

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Recent Changes (Last 90 Days)
LOWMay 26, 2026NCT04909801primaryCompletionDate: changed
LOWMay 24, 2026NCT04909801studyFirstPostDate: changed