What is abatacept and why is it prescribed?
Abatacept (trade name: Orencia) is a type of drug called a biological therapy. It works by interfering with the function of particular cells (T-cells) in the immune system. This action modifies the inflammation and immune activity which cause the symptoms of rheumatoid arthritis.
It's a long-term treatment, so it may be 6–12 weeks before you start to notice the benefits.
Abatacept can be prescribed by a rheumatologist for rheumatoid arthritis. It may be the first biological therapy you receive, or you may have tried others first such as an anti-TNF drug or rituximab. It's almost always used in combination with methotrexate.
Are there any reasons why I won't be prescribed abatacept?
Abatacept won't be started if:
Doctors sometimes use a score known as DAS28 to work out how active your arthritis is. This counts how many of 28 specific joints are tender and swollen, and looks at inflammation levels in a blood test. You'll also be asked to score how well you feel on a scale of 0 to 10.
Your doctor may decide not to prescribe abatacept if you're pregnant or breastfeeding, or if:
- you have an infection or have had repeated infections
- you're currently taking an anti-TNF drug
- you've had cancer.
You'll probably have blood tests before treatment starts to assess whether the drug will be suitable for you. Your doctor will need to check if you've previously been exposed to tuberculosis (TB). You may need a course of treatment for latent (asymptomatic) TB.
If you've previously had hepatitis you may need regular checks for this as abatacept may increase the risk of hepatitis being reactivated.
If you're taking other drugs alongside abatacept you'll also need to continue any blood tests required for these.