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Orencia
Orencia, the brand name for abatacept, is a biologic medication used to treat various autoimmune diseases, including rheumatoid arthritis (RA), psoriatic arthritis, and juvenile idiopathic arthritis. It works by inhibiting the activation of T-cells, which are involved in the inflammatory process that leads to joint damage in these conditions. By modulating the immune system, Orencia helps reduce pain, inflammation, and long-term joint damage.
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Frequently Asked Questions
How long does it take for Orencia to work?
It may take several weeks to a few months to notice improvements in symptoms, but patients often begin to see benefits within the first 2-3 months of treatment.
Can I take Orencia with other RA medications?
Orencia is often used in combination with methotrexate or other DMARDs, but it should not be combined with other biologics, such as TNF inhibitors, as this increases the risk of serious infections.
What should I do if I miss a dose of Orencia?
If you miss a dose of Orencia, contact your healthcare provider for guidance. For subcutaneous injections, you may take the missed dose as soon as you remember and then return to your regular schedule.
Can Orencia cause weight gain?
Weight gain is not a common side effect of Orencia, but some individuals may experience changes in weight due to other factors such as inflammation or steroid use.
How long can I take Orencia?
Orencia is intended for long-term use to manage conditions like RA and psoriatic arthritis. As long as it remains effective and well-tolerated, your healthcare provider may recommend continued treatment.
Comprehensive Drug Guide
How Does Orencia Work?
Orencia (abatacept) works by targeting and blocking the activation of T-cells, a type of white blood cell involved in the immune response. Specifically, Orencia binds to CD80 and CD86 on antigen-presenting cells (APCs), preventing them from fully activating T-cells. By reducing T-cell activation, Orencia helps to decrease the inflammation and immune response that contribute to joint damage in autoimmune diseases like RA.
Common Dosages
- Intravenous infusion: Based on body weight, given as a 30-minute infusion every 2 weeks for the first 3 doses, followed by every 4 weeks.
- Subcutaneous injection: 125 mg once weekly.
Typical Dosing
- For adults with RA or psoriatic arthritis:
- IV infusion: Dosing is based on body weight and typically starts with an infusion every 2 weeks for the first 3 doses, followed by a dose every 4 weeks.
- Subcutaneous injection: 125 mg once weekly, with or without an initial IV dose.
- For juvenile idiopathic arthritis: The dosing depends on the child’s weight and is usually given via IV infusion or subcutaneous injection.
Typical Dosing
FDA Approved Indications
- Rheumatoid arthritis (RA) in adults
- Psoriatic arthritis
- Juvenile idiopathic arthritis (JIA) in patients aged 2 years and older
Who Shouldn't Take Orencia?
- Known hypersensitivity to abatacept or any component of the formulation.
- Severe, uncontrolled infections such as sepsis.
- Active tuberculosis (TB) or other serious infections, unless treated or under control.
Advice From The Pharmacist
- Before starting Orencia, ensure that you have been tested for tuberculosis (TB) and other infections, as this medication can increase your risk of serious infections.
- Orencia can be self-administered as a subcutaneous injection or given as an IV infusion by a healthcare provider. If self-injecting, follow your healthcare provider's instructions carefully, including rotating injection sites.
- Do not receive live vaccines while taking Orencia, as this can increase your risk of infection. Inform your healthcare provider about any vaccines you need before starting treatment.
- Monitor for signs of infection such as fever, chills, or persistent cough. If any occur, contact your healthcare provider immediately.
- Store subcutaneous injections in the refrigerator and allow them to come to room temperature for 30 minutes before injecting. Do not freeze the medication.
Side Effects of Orencia
Common Side Effects
- Headache
- Nausea
- Upper respiratory infections (e.g., cold, sinus infection)
- Fatigue
- Injection site reactions (redness, swelling, pain)
Uncommon/Severe Side Effects
- Serious infections: Orencia can lower your immune system’s ability to fight infections, increasing the risk of pneumonia, sepsis, and other serious infections.
- Infusion reactions: Some individuals may experience allergic reactions during or after the infusion, including itching, rash, shortness of breath, or chest pain.
- Malignancies: While rare, there is a potential increased risk of cancers such as lymphoma when taking biologic medications like Orencia.
Risks and Warnings of Orencia
- Increased risk of infections: Orencia suppresses the immune system, increasing the risk of serious infections, including tuberculosis and bacterial infections. Patients should be monitored for signs of infection, and treatment should be discontinued if a serious infection develops.
- Lymphoma and other malignancies: There may be a slight increased risk of certain cancers, such as lymphoma, particularly in patients with RA who are already at higher risk for these cancers.
- Live vaccines: Patients should avoid live vaccines during treatment with Orencia, as the medication can weaken the immune response and increase the risk of developing infections from the vaccine.
Interactions with Orencia
Common Drug Interactions
- TNF inhibitors (e.g., Humira, Enbrel): Using Orencia with other biologic drugs that target the immune system can increase the risk of serious infections.
- Immunosuppressants: Orencia should not be combined with other potent immunosuppressants unless specifically recommended by a healthcare provider, as it can further increase the risk of infection.
- Live vaccines: Avoid live vaccines while on Orencia, as it can increase the risk of infections and reduce the effectiveness of the vaccines.
Alternatives to Orencia
- Humira (adalimumab): Another biologic used to treat RA, psoriatic arthritis, and other inflammatory conditions.
- Enbrel (etanercept): A TNF inhibitor used for autoimmune conditions, including RA and psoriatic arthritis.
- Methotrexate: A disease-modifying antirheumatic drug (DMARD) that is often used in combination with biologics like Orencia.
