Formulary
Abatacept: Indications, Dosing, Side Effects and Interactions
Abatacept clinical drug profile including indications, dosing, side effects, cautions and interactions.
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Abatacept: Indications, Dosing, Side Effects and Interactions
Abatacept clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Moderate-to-severe active rheumatoid arthritis (specialist use only),Active psoriatic arthritis (specialist use only)**
- **Adult** (By Subcutaneous Injection): 125 mg once weekly, review treatment if no response within 6 months, subcutaneous dosing may be initiated with or without an intravenous loading dose-consult product literature.
**Moderate-to-severe active polyarticular juvenile idiopathic arthritis (specialist use only) for abatacept**
- **Child 2-17 years (body-weight 10-24 kg)** (By subcutaneous injection): 50 mg once weekly, review treatment if no response within 6 months.
- **Child 2-17 years (body-weight 25-49 kg)** (By subcutaneous injection): 87.5 mg once weekly, review treatment if no response within 6 months.
- **Child 2-17 years (body-weight 50 kg and above)** (By subcutaneous injection): 125 mg once weekly, review treatment if no response within 6 months.
Cautions
Do not initiate until active infections are controlled; elderly (increased risk of side-effects); predisposition to infection (screen for latent tuberculosis and viral hepatitis); progressive multifocal leucoencephalopathy (discontinue treatment if neurological symptoms present)
Contraindications
Severe infection
Side effects
Common or very common Asthenia; cough; diarrhoea; dizziness; gastrointestinal discomfort; headaches; hypertension; increased risk of infection; nausea; oral ulceration; skin reactions; vomiting Uncommon Alopecia; anxiety; arrhythmias; arthralgia; bruising tendency; conjunctivitis; depression; dry eye; dyspnoea; gastritis; hyperhidrosis; hypotension; influenza like illness; leucopenia; menstrual cycle irregularities; neoplasms; pain in extremity; palpitations; paraesthesia; respiratory disorders; sepsis; sleep disorders; throat tightness; thrombocytopenia; vasculitis; vasodilation; vertigo; visual acuity decreased; weight increased Rare or very rare Pelvic inflammatory disease
Interactions
**Severe interactions:**
- While TNF-inhibitors did not influence abatacept clearance, in placebo-controlled clinical trials, patients receiving concomitant treatment with abatacept and TNF-inhibitors experienced more...
- Exploratory studies to assess the effect of abatacept on the antibody response to vaccination in healthy subjects as well as the antibody response to influenza and pneumococcal vaccines in...
**Other interactions (11):**
- Combination with TNF-inhibitors There is limited experience with the use of abatacept in combination with TNF-inhibitors (see section 5.1).
- Therefore, concurrent therapy with abatacept and a TNF-inhibitor is not recommended.
- Combination with other medicinal products Population pharmacokinetic analyses did not detect any effect of methotrexate, NSAIDs, and corticosteroids on abatacept clearance (see section 5.2).
- No major safety issues were identified with use of abatacept in combination with sulfasalazine, hydroxychloroquine, or leflunomide.
- Combination with other medicinal products that affect the immune system and with vaccinations Co-administration of abatacept with biologic immunosuppressive or immunomodulatory agents could...
- There is insufficient evidence to assess the safety and efficacy of abatacept in combination with anakinra or rituximab (see section 4.4).
Pregnancy
Manufacturer advises avoid unless essential.
Breast feeding
Present in milk in animal studies-manufacturer advises avoid breast-feeding during treatment and for 14 weeks after last dose.
Medicinal forms
Solution,Solution
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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