According to the National Institutes of Health (NIH), rheumatoid arthritis (RA) is an autoimmune disease in which the body launches an inflammatory response that affects joints, causing pain, swelling and joint damage. Abatacept, sold under the brand name Orencia, is a drug for those with moderate to severe RA that have not been helped enough by other types of medicines.
Identification
Abatacept is in a class of drugs described by the NIH as costimulation modulators or immunomodulators. It works by blocking the activity of T-cells, a type of immune cell that attacks the tissues, causing swelling and joint damage in people who have arthritis.
Features
Abatacept comes as a powder that must be mixed with sterile water. It is given intravenously, injected into a vein, by a nurse or doctor. The first two treatments are given about 15 days apart with a third dose on day 30, followed by treatments every four weeks. According to the manufacturer's patient information sheet, the infusion should last about 30 minutes.
Precautions
Since abatacept affects the body's immune system it can increase susceptibility to infection or make existing infections worse. Prior to receiving this medication it is important to report any type of infection, no matter how small. Testing will be done before starting this medicine to make sure that there is no infection from TB or hepatitis. Special precautions must be taken for those who have diabetes, chronic obstructive pulmonary disease (COPD) or a weak immune system. It is important that the physician be aware of all medications since possible interactions may require changes of dose and careful monitoring for side effects. Care must be taken if surgery or dental work is to be done, since abatacept can slow healing. Some vaccines should not be taken while on abatacept or for three months after taking this medicine. The manufacturer states that abatacept has not been studied in pregnant or nursing women.
Side Effects
Side effects should be reported if they do not go away or are severe, including headache, runny nose and sore throat. Nausea, dizziness and heartburn have also been noted, along with pains in the arms, legs and back. More serious side effects should be reported immediately and include hives, rash or itching. Swelling of the eyes, mouth or throat and shortness of breath could be life threatening and must be reported immediately. Other serious side effects can include night sweats, weight loss, and urinary urgency, difficulty or burning. Cellulitis, indicated by warmth, redness and swelling of the skin, may also occur. Certain types of cancer have also been reported in people receiving Abatacept.
Other Considerations
Generally there are no diet restrictions while receiving treatment with abatacept. Make a list of all medicines, prescription and over-the-counter, and take to every doctor appointment or visit to the hospital. In cases of emergency it is important for health care providers to know if a person is taking this medicine. Abatacept should be received on a regular schedule and doses should not be missed, so make appointments in advance.
