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ABATACEPT IV (Orencia®) INFORMATION SHEET
Developed by Andy Thompson MD FRCPC (November 8, 2011)
What is Abatacept?
Abatacept is a biologic. It is currently used for the treatment of Rheumatoid arthritis.
How does Abatacept work?
In some people with inflammatory arthritis the cells of the immune system become confused and mistake the cells of the body’s joints for foreign invaders and decide to “attack” the joints (autoimmune). The T-cell is an important immune cell, which, when activated (turned on), is responsible for this attack. Abatacept is a protein which helps to stop T-cells from becoming activated (turned on). By preventing T-cell activation, abatacept works by suppressing the body’s immune system. Although this suppression can make it slightly harder for you to fight off infections, it also helps to stabilize an overactive immune system.
Why am I taking Abatacept?
Your doctor has prescribed this medicine to help with the following:
- Reduce the pain and swelling (inflammation) in your joints.
- Improve your day to day function.
- Prevent long-term damage from the joint inflammation.
What is the usual dose of Abatacept?
- Abatacept is given by an intravenous (IV) infusion.
- The normal starting dose is typically 500 to 1000 mg which is based on your body weight.
- Methotrexate is commonly used in combination with abatacept which may improve your response to the medication.
How often do I take Abatacept?
- You will receive your first dose of abatacept on week 0. The second dose is given on week 2 and the third dose on week 4.
- The maintenance dose begins 4 weeks after the third dose and infusions are then given every 4 weeks thereafter. The infusions usually take about 30-60 minutes.
Who Should NOT take Abatacept?
- Patients who have had a previous serious allergic reaction to abatacept.
- Women who are pregnant, planning on becoming pregnant, or breast feeding.
- Possibly patients who have cancer or have had a past history of certain cancers.
- Patients with active infections (such as tuberculosis).
When will I start to feel the effects of Abatacept?
Abatacept may take about 2 weeks before you start to feel the effects. Some patients notice benefit with the first dose and with others it may take several weeks. It may take 4 to 12 weeks before you feel a lot of benefit.
What should I AVOID while taking Abatacept?
- You should discuss all vaccinations with your doctor as some vaccines are not advisable while you are taking abatacept.
- If you are scheduled for surgery, please tell your doctor.
When should I NOT TAKE my Abatacept?
You contact your doctor before missing any infusion of abatacept. In the following situations, it would be advisable to stop the abatacept:
- If you have a fever.
- If you have or think you have an infection.
- If you think you are pregnant.
Which Medications are safe to take with Abatacept?
Your rheumatologist may decide to add other medications to treat your arthritis.Nearly all medications are safe to take with abatacept (except some of the other biologic agents). As an example, some of the other medications which may be safely added to abatacept include: Acetaminophen (Tylenol), Prednisone, anti-iflammatory drugs (NSAIDS) and other DMARDs.
What are the side-effects of Abatacept?
MORE COMMON (usually temporary) side-effects include:
- Nausea & diarrhea
- Back pain
- Rash, flushing
- Headaches or dizziness
- Upper respiratory tract infections (such as sinusitis). If you have an infection you should get in touch with your rheumatologist or family physician
RARE side-effects include:
- Infusion Reaction – Rarely patients may react to the medication during or shortly after the infusion.
- Infection – As is the case with many medications used in the treatment of arthritis there is an increased risk of serious infections associated with the use of abatacept. Any infections or fevers should be taken very seriously and reviewed by your doctor.
- Lungs – May worsen symptoms of COPD and pneumonia
- Malignancy – Abatacept may be associated with a small increased risk of developing certain types of cancer. Please discuss it with your rheumatologist.
How can I help to minimize the side-effects of Abatacept?
- Take your abatacept as prescribed by your doctor.
- All patients should have a TB (tuberculosis) skin test and a chest x-ray before starting abatacept.
Do I need to have regular blood tests while taking Abatacept?
Blood tests are not routinely required while you are taking abatacept. However, your doctor will likely order periodic blood tests to check your blood counts and follow the activity of your arthritis, especially if you are on other DMARDs.
How do I stop the Abatacept?
You do not need to wean yourself off the abatacept. It can simply be stopped. However, your arthritis will likely “flare” a few weeks after you stop the medicine.
What should I do if I miss a dose of Abatacept?
If you miss your abatacept infusion contact your doctor to find out when to reschedule for your next infusion.
Is Abatacept safe in pregnancy?
Abatacept is a new medication and it is unknown if it is safe to use in pregnancy. Therefore, you should AVOID PREGNANCY while on abatacept. All women of child bearing potential taking abatacept must use reliable contraception.
- If you become pregnant while taking abatacept NOTIFY YOUR DOCTOR IMMEDIATELY.
- There is no safety information on breast feeding while taking abatacept so breast feeding can not recommended.