abatacept

Actions and Spectrum:

abatacept is a biologics medication used to treat autoimmune disorders such as rheumatoid arthritis. It works by inhibiting the activation of T cells, involved in the body’s immune response.

It leads to a reduction in the inflammation and joint damage that occurs in autoimmune disorders. abatacept is an immunomodulatory drug that modulates or regulates the immune system. It is administered by intravenous infusion.

DRUG INTERACTION

Contraindicated  

Serious Use Alternative  

Monitor Closely  

Minor  

>10%:

Headache (18%)

Nasopharyngitis (12%)

Nausea (>10%)

1-10%:

Dizziness (9%)

Cough (8%)

Hypertension (7%)

Back pain (7%)

Urinary Tract Infection (6%)

Dyspepsia (6%)

Pain in extremities (3%)

Rash (4%)

<1%:

Anaphylaxis

COPD exacerbation

Cellulitis

Disease flare

Dyspnea

Diverticulitis

Hypersensitivity

Joint wear

Lymphoma

Pruritus

Urticaria

Rhonchi

Wheezing

Varicella infection

Frequency Not Defined:

Nausea

Diarrhea

Abdominal pain

Black Box Warning:

It is essential to follow the dosage and administration instructions for the medication carefully.

Contraindication/Caution:

abatacept is contraindicated in individuals with hypersensitivity to abatacept or its components.

Cautions:

• Active infections: abatacept should not be used in individuals with active infections.
• Tuberculosis: abatacept should be used with caution in individuals with a history of tuberculosis or at risk of developing tuberculosis.
• Vaccination: abatacept may impair the body’s ability to respond to vaccinations. The individuals receiving abatacept should be up to date on their vaccinations.

Pregnancy consideration:

Category C.

Breastfeeding warnings:

The presence of the drug in breast milk and its effect on lactating infants is unknown.

Pregnancy category:

Category A: well-controlled and Satisfactory studies do not show risk to the fetus in the first/later trimester.

Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women.

Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.

Category D: adequate data available with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.

Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.

Category N: No data is available for the drug under this category.

Pharmacology

abatacept is a biologics medication that modulates the immune system to reduce inflammation in autoimmune disorders. It is a selective co-stimulation modulator that binds to CD80 and CD86, co-stimulatory molecules on antigen-presenting cells (APCs).

By binding to these co-stimulatory molecules, abatacept interferes with the interaction between APCs and T cells, involved in the body’s immune response. It reduces T cells’ activation, reducing inflammation and joint damage in autoimmune disorders such as rheumatoid arthritis.

Pharmacodynamics:

abatacept is a biologics medication that blocks the activation of T-cells, involved in the body’s immune response. It specifically targets the co-stimulatory signal needed for T-cell activation, thus reducing inflammation, and slowing down the progression of autoimmune diseases such as rheumatoid arthritis. abatacept modulates the immune system by binding to CD80 and CD86 on antigen-presenting cells, preventing the interaction with CD28 on T-cells. This results in a decreased activation of T-cells and decreased production of pro-inflammatory cytokines, leading to reduced inflammation and joint damage.

Pharmacokinetics:

After SC administration, abatacept is absorbed more slowly, with peak plasma concentrations occurring between 24-72 hours.

Following IV administration, abatacept is rapidly distributed into the bloodstream, with peak plasma concentrations occurring within 1-2 hours.

The drug is then slowly cleared from the body through metabolism and excretion.

Terminal Half-life: 13 days

Peak Plasma concentration: 295 mcg/mL

The volume of distribution: 0.07 L/kg

Rate of Clearance: 0.22 mL/hr/kg

Administration:

Administer the medication intravenously or subcutaneously. Dilute the powder with 10 ml of sterile water for injection to obtain 25 mg/ml of solution.

Patient information leaflet

Generic Name: abatacept

Pronounced: ab-a-tah-sept

Why do we use abatacept?

abatacept treats Rheumatoid Arthritis, Psoriatic Arthritis, Graft versus Host Disease, and Juvenile Idiopathic Arthritis in children.