Abatacept

Drug Name
Abatacept

Brand Name(s)
Orencia®

Drug Class
Biologic

Abatacept is used to treat inflammatory types of arthritis, such as rheumatoid arthritis (RA).

  • What types of arthritis is abatacept used for?

    Abatacept is used to treat inflammatory types of arthritis, such as rheumatoid arthritis (RA).

    For the treatment of RA, abatacept may be used as monotherapy or in combination with DMARD therapy, such as methotrexate (MTX). In recently diagnosed patients who have not been previously treated with MTX, abatacept should be given in combination with MTX (unless MTX cannot be taken).

  • How is abatacept administered?

    Abatacept is delivered through infusion once a month or via subcutaneous (s.c.) injection (meaning in the fatty layer of tissue just under the skin) once a week.

  • What is the typical dose and when do I take it?

    When given by infusion the dose of abatacept depends on your body weight, but a typical dose ranges from 500 to 1,000 mg once a month. After your first infusion you will receive another in two weeks, then every four weeks. The medication comes in a single-use vial for administration by infusion. Each infusion takes about 30 to 60 minutes.

    When given by s.c. injection, the dose of abatacept is 125 mg weekly. The medication comes in single use pre-filled syringes for administration. Some people may require an initial infusion loading dose prior to starting abatacept by s.c. injection.

    Abatacept pre-filled syringes cannot be used for infusions. Single-use vials for infusions cannot be used for s.c. injections.

  • How long will it take to work?

    As with all of the biologics, you may not feel the effects of abatacept right away. Some people begin to feel the effects of the medication fairly quickly; however, it may take three to six months to feel its full effect. It is important to be patient and keep taking your medication.

    To provide symptom relief while you are waiting for abatacept to take effect, your health-care provider may recommend taking a steroid, such as prednisone, or a non-steroidal anti-inflammatory drug (NSAID).

  • When should I not take abatacept and call my doctor?

    Taking abatacept can make it more difficult for your body to fight infections. Therefore, people with active infections should not take abatacept. If you have a fever, think you have an infection or have been prescribed an antibiotic, contact your health-care provider. People who have had frequent infections in the past or a history of tuberculosis should discuss the use of abatacept with their health-care provider.  Also, contact your health-care provider if you are having surgery as you may need to stop abatacept until you are healed and there is no sign of infection.

    Abatacept has not been studied in pregnant women or nursing mothers so its effect(s) on pregnant women or nursing babies are unknown. You should tell your doctor if you are pregnant or are planning to become pregnant. Because of the potential for adverse reactions in nursing infants, a decision should be made with your health-care provider on whether or not to discontinue nursing or the medication, taking into account the importance of the drug to the mother.

    Anyone who has had a previous allergic reaction to abatacept should avoid the medication.
    People with a history of cancer or emphysema should discuss the use of abatacept with their health-care provider.

    Ideally, your vaccinations should be up to date prior to starting an abatacept. If you have already started therapy with abatacept, your health-care provider will likely recommend most inactive vaccines (e.g., influenza, pneumococcal). Live vaccines are not recommended due to risk of causing infection. Before receiving any vaccinations while taking abatacept, you should speak with your health-care provider.

  • What are the side effects of abatacept?

    Like all medications, taking abatacept carries some risk of side effects, which must be balanced with the potential benefits. In general, the risk of joint damage and permanent disability (resulting from arthritis) is much greater than the risks of side effects from abatacept. When monitored properly the vast majority of side effects are rare, most improve over time and are reversible.

    Firstly, abatacept can increase your risk of infections.

    In rare cases, people may experience headaches, nausea, back pain and a rash while taking abatacept. If these symptoms become severe please consult your health-care provider.

    Also in uncommon circumstances, abatacept can cause an allergic reaction during the infusion (flushing, itching, changes in heart rate and blood pressure, etc.). A health-care provider will monitor for this reaction during the infusion. For people taking the medication by injection, abatacept can in rare instances cause an injection site reaction (redness, pain and itching). Talk to your health-care provider if these symptoms become severe.

  • What helps to reduce side effects?

    Take abatacept as prescribed and contact your health-care provider if you have any concerns while taking the medication.

    If you experience an infusion reaction while taking abatacept, prior to your next infusion your health-care provider may recommend a medication pre-treatment to prevent a reaction. Your prescriber may also recommend a longer infusion time.

    To avoid injection reactions, injection sites should be rotated and injections should never be given into areas where the skin is tender, bruised, red and/or hard.

  • Do I need any monitoring while taking abatacept?

    Blood tests are not routinely required while you are taking abatacept. Your health-care provider may order periodic blood tests to check your blood count and follow the activity of your arthritis.


This information was last updated November 2017, with expert advice from:

Jason Kielly, B.Sc. (pharm.), Pharm.D.
Assistant Professor, School of Pharmacy, Memorial University of Newfoundland
Clinical Pharmacist, Rheumatic Health Program, Eastern Health

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