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Updated April 2019
Abatacept (brand name Orencia) belongs to a new class of medicines called biological disease modifying antirheumatic drugs (biological DMARDs or bDMARDs). bDMARDs have now been given to over a million people worldwide since their initial use in the late 1990s.
These medicines block natural substances called cytokines. These are substances found in excessive amounts in the blood and joints of people with rheumatoid arthritis and juvenile arthritis. The increased levels of cytokines cause inflammation, which results in symptoms of pain, joint swelling and stiffness, and can lead to joint damage. By blocking T cell (a type of white blood cell) responses, abatacept reduces inflammation, lessens the symptoms and helps stop further joint damage.
Unlike standard antirheumatic drugs (DMARDs), abatacept works relatively quickly. You may notice some relief of joint swelling, pain and stiffness within the first 4-8 weeks of treatment.
If abatacept treatment is stopped for more than a few weeks there is a risk that your condition may worsen. Continue with your treatment unless advised by your doctor or unless side effects develop (see Side effects). If you stop abatacept for any reason you must contact your doctor. Failure to do so may mean that your continued treatment may no longer be subsidised.
In view of the current prescribing restrictions for all bDMARDs:
Abatacept is given as a drip (infusion) into the vein, or as an injection under the skin of the abdomen or thigh. The infusion normally takes thirty minutes. This is followed by a one hour period of observation to make sure you don’t have any side effects. Additional doses are usually given at 2 and 4 weeks after the first dose. Subsequent doses are usually given every 4 weeks. When given as an injection under the skin (subcutaneous injection), doses are given weekly. The treatment may still begin with a single dose given as an infusion (loading dose).
Abatacept is given in combination with the DMARD methotrexate.
For infusions the dose is based on the person’s weight, so each person’s dose may be different. The subcutaneous dose is a standard 125mg weekly injection.
Abatacept may be used with other arthritis medicines including:
Abatacept cannot be used with other bDMARDs. There are separate information sheets for the medicines mentioned above.
You might experience side effects with your treatment. Contact your doctor if you have any concerns about possible side effects. Many side effects disappear when abatacept treatment is stopped.
Common possible side effects include:
Less common or rare possible side effects:
Precautions with other diseases
Use with other medicines
Use with alcohol
Use in pregnancy and when breastfeeding