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ABATACEPT SC (Orencia®) INFORMATION SHEET
Developed by Andy Thompson MD FRCPC (February 1, 2013)
What is Abatacept SC?
Abatacept is a biologic. It is currently used for the treatment of Rheumatoid arthritis.
How does Abatacept SC 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 SC?
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 SC?
- Abatacept SC is given by an injection under the skin.
- The normal dose is 125 mg given once a week.
- Methotrexate is commonly used in combination with abatacept SC which may improve your response to the medication.
How often do I take Abatacept SC?
- Abatacept SC is given once a week by injection under the skin.
Who Should NOT take Abatacept SC?
- 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 SC?
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 SC?
- 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 SC?
You contact your doctor before missing an injection of abatacept SC. In the following situations, it would be advisable to stop the abatacept SC:
- 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 SC?
Your rheumatologist may decide to add other medications to treat your arthritis.Nearly all medications are safe to take with abatacept SC (except some of the other biologic agents). As an example, some of the other medications which may be safely added to abatacept SC include: Acetaminophen (Tylenol), Prednisone, anti-iflammatory drugs (NSAIDS) and other DMARDs.
What are the side-effects of Abatacept SC?
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:
- Injection Site Reaction – Redness, swelling, and discomfort around the area injected.
- 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 SC. Any infections or fevers should be taken very seriously and reviewed by your doctor.
- Lungs – May worsen symptoms of COPD and pneumonia
- Malignancy – Abatacept SC 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 SC?
- 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 SC.
Do I need to have regular blood tests while taking Abatacept SC?
Blood tests are not routinely required while you are taking abatacept SC. 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 SC?
You do not need to wean yourself off the abatacept SC. 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 SC?
If you miss your abatacept SC injection simply give your next injection on your next regularly scheduled day.
Is Abatacept safe in pregnancy?
Abatacept SC is a new medication and it is unknown if it is safe to use in pregnancy. Therefore, you should AVOID PREGNANCY while on abatacept SC. All women of child bearing potential taking abatacept SC must use reliable contraception.
- If you become pregnant while taking abatacept SC NOTIFY YOUR DOCTOR IMMEDIATELY.
- There is no safety information on breast feeding while taking abatacept SC so breast feeding can not recommended.