What is Abatacept (Orencia®)?
Abatacept is approved for adults with rheumatoid arthritis (RA), adults with psoriatic arthritis, and children 2 years of age and older with polyarticular juvenile idiopathic arthritis. Abatacept reduces the signs and symptoms of these diseases, such as joint swelling, pain, and fatigue. The brand name for abatacept is Orencia. It is part of a class of drugs called biologics.
How do I take it?
Abatacept may be given as an injection under your skin that you administer yourself, similar to insulin injections. It may also be administered to you as an infusion (intravenous medication).
The abatacept subcutaneous injections (shots) are available as a 125mg prefilled syringe or auto-injector (pen). It is given once a week. You will be instructed on how to give yourself injections.
If you have RA, your doctor may choose for you to have an intravenous (IV) loading dose before starting the abatacept injections. For these patients, the first subcutaneous injection is given within a day of the intravenous infusion.
The intravenous (IV) infusion is given to you by a healthcare professional. This procedure usually takes about 30 minutes. After you receive your first dose you will get your second dose two weeks later and the third dose at four weeks from the first infusion. After the third dose, you will then be given infusions every four weeks.
If you are being switched to the subcutaneous injection from the intravenous infusion, the first injection should be given instead of the next scheduled intravenous infusion.
What about side effects?
Some common side effects that patients report are headaches and nausea.
For patients who are using the subcutaneous injections, the medicine can cause slight irritation near the injection site. If this happens, the discomfort should be mild. If you have pain, swelling, warmth, or discoloration near the injection site, you should contact your healthcare provider.
Allergic reactions may happen. Call your healthcare provider or an emergency medical provider if you have any signs of an allergic reaction, such as rashes or hives; swollen face, eyelids, lips, or tongue; and difficulty breathing.
The most common serious side effect is infection. Abatacept can lower the body’s ability to fight infection. Be sure to contact your physician if have any signs of infection, such as fever, fatigue, cough, or red or painful skin. You may have to stop abatacept while being treated for an infection. You may also need to stop abatacept if you are planning a surgery.
You will need to have a negative tuberculosis (TB) skin test before beginning abatacept therapy. Your doctor may also want to check your blood to make sure you do not have Hepatitis B or C.
Make sure your doctor knows if you have chronic obstructive pulmonary disease (COPD), because abatacept may cause you to have more frequent breathing problems if you have COPD.
You should not be given any live vaccines, such as Flu-Mist (the nasal-spray flu vaccine), the chicken pox vaccine, the shingles vaccine or the measles vaccines, while on abatacept or within three months of stopping abatacept. The flu-shot (flu injection vaccine) is not a live virus and all patients should consider having this vaccination yearly.
What about other medications?
Many patients need to continue another oral medication for RA, like methotrexate or plaquenil, while on abatacept, and should continue to take this if advised to do so by their doctor.
Never take Abatacept with any TNF blocker such as Humira®, Enbrel®, or Remicade®, or any other biologic medication used to treat RA.
When you are taking Abatacept, it is very important that your doctors know if you are taking any other medicine. This includes prescription and non-prescription medicines as well as birth control pills, vitamins, and herbal supplements.
What else should I know?
The abatacept syringes should be kept in the refrigerator in the original carton. Do not freeze this medicine.
You must continue your regular visits to the rheumatologist. Your doctor will monitor you for any improvements in your rheumatoid arthritis and for any signs of infections. It may take two months of Abatacept treatment before any improvement in symptoms occurs.
Your doctor will need to monitor your blood to make sure you are not getting any side effects from abatacept or other medications you may be taking.
A Federal Drug Administration patient information guide is available online at: