Abatacept Drug information

Abatacept is used to treat rheumatoid arthritis. Abatacept should effectively treat your Your doctor may decide not to condition, and stop it causing damage prescribe abatacept if you’re to your joints. It has been tested and pregnant or breastfeeding, or if: has helped many people. However, • you have an infection as with all drugs some people will • you’re currently taking have side-effects. This leaflet sets an anti-TNF drug out what you need to know. • you’ve had repeated infections • you’ve had cancer. What is abatacept and You’ll probably have blood tests how is it used? before treatment starts to assess Abatacept (trade name Orencia) is your disease and whether the drug a type of drug called a biological is suitable for you. Your doctor will need to check if you’ve previously therapy. It works by interfering been exposed to tuberculosis (TB), with the function of particular cells and you may need a course of (T-cells) in the immune system. This treatment for latent (asymptomatic) action modifies the inflammation TB before starting abatacept. and immune activity which cause the symptoms of rheumatoid If you’ve previously had hepatitis arthritis. It’s a long-term treatment, you may need regular checks for this so it may be 6–12 weeks before as abatacept may increase the risk you start to notice the benefits. of the hepatitis being reactivated. Abatacept can be prescribed by If you’re taking other drugs a consultant rheumatologist for alongside your abatacept (such as methotrexate) you’ll also need to rheumatoid arthritis. It may be the continue your blood tests for these. first biological therapy you receive, or you may have tried others first, such as an anti-TNF drug or rituximab. Abatacept won’t be started if: • your arthritis isn’t active • you haven’t tried at least Abatacept normally two disease-modifying anti- starts to work rheumatic drugs (DMARDs) such within 6–12 weeks. as methotrexate, sulfasalazine or leflunomide (abatacept is almost always used in combination with methotrexate). When and how do I take abatacept? Abatacept may be given: • either through a drip into a vein Abatacept needs to (intravenous infusion) which takes 1–2 hours once a month, be taken regularly in hospital or at a special clinic to help prevent your • or as an injection under the skin symptoms returning. (subcutaneous injection) once a week using a pre-filled syringe or pen. You, your partner, or another family member can learn to give these injections at home. Speak to your rheumatology team if you’re already having abatacept by infusion and wish Because abatacept affects your to switch to injections – you’ll immune system you may be more probably start your injections likely to pick up infections. It can when your next infusion is due. also make them harder to spot. The If you’re more than three days most common are chest and urinary late taking a dose, ask your infections, rhinitis and conjunctivitis. rheumatology team for advice on Tell your doctor or rheumatology when to take your next dose. nurse straight away if you develop Because it’s is a long-term treatment, any symptoms such as a sore throat it’s important to keep taking abatacept or fever, a persistent cough, weight (unless you have severe side-effects): loss or any other new symptoms that concern you. You should also tell your • even if it doesn’t seem to rheumatology team if you have any be working at first of these symptoms before having • even when your symptoms an infusion or injection. They may improve (to help keep the advise you to delay the treatment. disease under control). You should also see your doctor if you develop chickenpox or shingles Possible risks and side-effects or come into contact with someone Some side-effects can happen who has chickenpox or shingles. around the time of the infusion or These illnesses can be severe if you’re injection. The most common are on abatacept. You may need antiviral dizziness, headaches and feeling sick treatment, and your abatacept may (nausea). These aren’t usually serious. be stopped until you’re better. Some people have an allergic reaction with sudden swelling, a rash or breathlessness. This is very rare, but if you do develop these Speak to your symptoms, or any other severe rheumatology symptoms, during or soon after a team if you’re dose of abatacept you should seek having infusions medical advice immediately. and would like There may be a slightly increased to change to risk of some cancers when using injections. drugs like abatacept which interfere with the immune system, though research hasn’t so far confirmed this.

Reducing the risk of infection • Try to avoid close contact with • Don’t take over-the-counter people with severe active infections. preparations or herbal remedies • For advice on avoiding infection without discussing it first with from food, visit: http://www.nhs. your rheumatology team. uk/conditions/food-poisoning/ It’s recommended that you carry pages/prevention.aspx a biological therapy alert card, so anyone treating you will know that Taking other medicines you’re on abatacept – ask your rheumatology team for a card. You’ll probably be taking methotrexate as well as abatacept. Check with your doctor before Vaccinations starting any new medications, It’s usually recommended that people and remember to mention you’re on abatacept avoid live vaccines such on abatacept if you’re treated as yellow fever. Sometimes however, by anyone other than your a live vaccine may be necessary usual rheumatology team. – for example rubella vaccination • You can carry on taking non- in women of childbearing age. steroidal anti-inflammatory If you’re offered shingles vaccination drugs (NSAIDs) or painkillers, (Zostavax) it’s best if you can have this if needed, unless your doctor before starting abatacept. Shingles advises otherwise vaccination isn’t recommended for people who are already on abatacept. Pneumococcal vaccine (which gives We don’t yet know how abatacept protection against the commonest might affect an unborn baby but it cause of pneumonia) and yearly does not cross the placenta until 16 flu vaccines don’t interact with weeks of pregnancy so it’s unlikely abatacept and are recommended. to be harmful if taken in the first three months of pregnancy. To be Having an operation on the safe side, however, women of childbearing age are advised to use Talk this over with your specialists. contraception while on abatacept. It’s likely you will be advised If you’re planning to become to stop abatacept for a time pregnant, you should continue before and after surgery. to use contraception for three months after stopping abatacept. Alcohol It’s also unknown whether abatacept There’s no known interaction affects men who are trying to between abatacept and alcohol. father a baby. There’s no evidence However, if you’re also taking to suggest that it’s harmful but methotrexate, this can interact it’s probably a good idea for men with alcohol and damage your to take contraceptive precautions liver so you should keep well for at least three months after within the recommended limits of stopping treatment. For men who no more than 14 units of alcohol are also taking methotrexate, per week for adults unless your current guidelines state that this doctor advises a lower limit. drug doesn’t need to be stopped when trying to father a child. Fertility, pregnancy Breastfeeding isn’t recommended and breastfeeding if you’re on abatacept because the If you’re planning to try for a baby, effects are unknown You shouldn’t if you become pregnant or if you’re restart your abatacept until thinking of breastfeeding we suggest you’ve stopped breastfeeding. you discuss your medications with your rheumatologist. Arthritis Research UK Thank you for supporting Arthritis works to improve the Research UK. With your generosity we can keep doing our vital work. quality of life for people To donate visit with arthritis so that www.arthritisresearchuk.org/donate they can say they are in control, independent and recognised.

We’re dedicated to funding research into We would like to thank the team of people the cause, treatment and cure of arthritis who contributed to the development of this so that people can live pain-free lives. booklet. It was written by and updated by Dr David Walker and updated by Dr Ian Giles. An For more expert information visit our Arthritis Research UK medical advisor, Dr Ben website or if you would like to tell us Thompson, is responsible for the content overall. what you think about our booklets email [email protected] Please note: we have made every effort to or write to the address below. ensure that this content is correct at time of publication, but remember that information Arthritis Research UK about drugs may change. This information sheet is for general education only and does Copeman House not list all the uses and side-effects associated St Mary’s Gate with this drug. Chesterfield S41 7TD 0300 790 0400 www.arthritisresearchuk.org

@ArthritisRUK /arthritisresearchuk

Date published: 2015. Registered charity in England and Wales no. 207711, Scotland no. SC041156. ©Arthritis Research UK 2015 A Company registered in England and Wales. Limited by Guarantee no. 490500. 2249/D-ABAT/15-1