One form of abatacept is given by injection (infusion) into a vein
(intravenously, or IV) every 4 weeks.
Another form of abatacept is injected under the skin every week.
Abatacept is a man-made protein that
interferes with T-cells. T-cells are part of your immune system and help cause
inflammation and joint damage in
rheumatoid arthritis. Abatacept affects rheumatoid
Abatacept is a disease-modifying antirheumatic drug
(DMARD), which means it slows the progression of rheumatoid arthritis. DMARDs
are also called immunosuppressive drugs or slow-acting antirheumatic drugs
Abatacept may be used alone or in combination with
other DMARDs such as methotrexate. But abatacept is not used in combination
with the other biologic DMARDs adalimumab (Humira), anakinra (Kineret),
etanercept (Enbrel), and infliximab (Remicade).
Abatacept has been approved for use in
adults with moderate to severe rheumatoid arthritis who have not been helped by
one or more other medicines.
Abatacept improves symptoms of
rheumatoid arthritis in people who have not been helped by other medicines.
Abatacept slows the progression of joint damage caused by rheumatoid arthritis.
Studies also showed that after abatacept treatment, people had better physical
Because abatacept is a protein that is
injected (infused) into the vein, your body may have a reaction to the
infusion. You will be given acetaminophen and diphenhydramine before infusions
to prevent chills and lightheadedness. But some people cannot adjust to the
infusion and cannot tolerate the treatment. Although an infusion can be
uncomfortable, frightening, and potentially serious, the effects can be treated
and reversed rapidly.
During the infusion, you may have an
infusion reaction, including:
After the infusion, common side effects with abatacept
Abatacept decreases the activity
of your body's immune system, which increases the risk of a serious bacterial
infection. Some people who take abatacept will develop an infection that
requires oral antibiotics; a smaller number of people will develop an infection
that requires intravenous antibiotics and hospitalization. Contact your doctor if you develop any of the following symptoms:
Abatacept can reactivate
tuberculosis (TB) in people who have been previously
infected with TB. Before starting abatacept treatment, you should be screened
with a tuberculin skin test and a chest X-ray. If the skin test is positive or
the chest X-ray suggests previous exposure to TB, you will need treatment to
prevent active TB.
People with rheumatoid arthritis have a
slightly higher risk of getting cancer of the lymph glands, called
lymphoma, than people without rheumatoid arthritis.
But lymphoma is rare even for people with rheumatoid arthritis. Experts do not
know why this risk is higher for people with rheumatoid arthritis—it may be
because the disease is severe or because of the medicines used to treat it.
Studies are currently under way to explain this. Talk with your doctor about
the benefits and risks of DMARD therapy.
See Drug Reference for a
full list of side effects. (Drug Reference is not available in all
Abatacept should not be used by
pregnant women or women of childbearing age who are not using reliable birth
control. If you are going to take abatacept, you should be on some form of
reliable birth control. If you plan to become pregnant, check with your doctor before stopping birth control and trying to become
Talk to your doctor before taking abatacept
if you are breast-feeding because abatacept may pass into breast milk.
Talk to your doctor if you also have
chronic obstructive pulmonary disease (COPD).
Abatacept may cause more side effects in people with COPD.
One form of abatacept is given by an injection (infusion) into a vein
(intravenously). An IV is inserted into your arm and the medicine is given
slowly. An infusion takes about 30 minutes. You will take diphenhydramine and
acetaminophen before the infusion to prevent reactions to the infusion, such as
lightheadedness or general discomfort.
Another form of abatacept is injected under the skin. This form can be self-administered after you are trained by your doctor.
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CitationsAbatacept (Orencia) for rheumatoid
arthritis (2006). Medical Letter on Drugs and Therapeutics, 48(1229): 17–18.
August 23, 2011
Anne C. Poinier, MD - Internal Medicine & Stanford M. Shoor, MD - Rheumatology
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