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Orencia (Abatacept)

Orencia (Abatacept) is a biologic medication used to treat rheumatoid arthritis, as well some other types of arthritis.

Orencia is a synthetic protein that suppresses the body’s immune system. It prevents an important type of immune system cell, the T-cell, from turning on and becoming “activated”. In a patient whose arthritis is caused by their immune system attacking their own joints by mistake, Orencia helps to hold back the attack from T-cells.

Taking Orencia

Orencia is available as a weekly subcutaneous (under the skin) injection (Orencia SC) and a monthly IV infusion (Orencia IV).

The injection can be done quickly at home. The IV infusion can be done in a specialized clinic, or it can be done as a home infusion.

The normal dose for the injection is 125 mg, once a week. Subcutaneous injections are easy to do compared to other types of injections. Patients can do them quickly at home. A small needle pokes just under the skin to deliver medicine into the “fatty tissue” below.

The starting dose for IV infusions is 500 to 1000 mg, depending on body weight. Patients receiving infusions are “ramped up” to a regular schedule when they get started. The first dose is administered at week 0. The second dose is given on week 2, and the third dose on week 4. The “maintenance dose” begins 4 weeks after the third dose and infusions are then given every 4 weeks after that. It can take about 30-60 minutes to receive an infusion at a clinic.

Orencia often takes 6-8 weeks before patients start feeling any effects. Some patients may notice benefit right after the first dose, and with others it can take several weeks. It can take 3-6 months before patients feel a lot of benefit.

Methotrexate is commonly prescribed in combination with Orencia, which can improve a patient’s response.

Important Tests and Risks

Orencia can make it a bit harder for people to fight off infections. Patients taking this medicine should call their doctor they have a fever, think they have an infection, or have been prescribed antibiotics to treat an infection.

Patients should coordinate with their doctor to stop treatment before any surgery. It can be re-started once things have healed and there’s no sign of infection.

Patients should discuss all vaccinations with their doctor because some are not advisable to get while taking Orencia.

It is important to get a TB (tuberculosis) skin test and a chest x-ray before starting Orencia.

Orencia is a newer medication so there is no reliable information about its safety in patients who are pregnant or breastfeeding. It is recommended to avoid pregnancy or breastfeeding while taking it.

Drug Identification Number (DIN): 02282097 (IV), 02402475 (SC)