Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
DRUG CLASS AND MECHANISM: Abatacept is an injectable, synthetic
(man-made) protein produced by recombinant DNA technology that is used for
treating rheumatoid arthritis.
The immune system is responsible for protecting the body
against foreign invaders, for example, infectious agents such as bacteria. In
patients with rheumatoid arthritis, however, the immune system attacks and destroys normal
tissue in and around the joints, causing pain, inflammation and damage to bone
and cartilage.
T-lymphocytes are important cells of the immune system. Patients with
rheumatoid arthritis have increased numbers of T-lymphocytes within the joints
that are inflamed. The T-lymphocytes are "activated," that is, they multiply and
release chemicals that promote the destruction of tissues surrounding the joints
and cause the signs and symptoms of rheumatoid arthritis.
Abatacept acts like an antibody and attaches to a protein on the surface of
T-lymphocytes. By attaching to the protein, abatacept prevents the activation of
the T-lymphocytes and blocks both the production of new T-lymphocytes and the
production of the chemicals that destroy tissue and cause the symptoms and signs
of arthritis. Abatacept slows the damage to bones and cartilage and relieves the
symptoms and signs of arthritis. Abatacept was approved by the FDA in December,
2005.
PRESCRIPTION: Yes
GENERIC AVAILABLE: No
PREPARATIONS: Powder for Injection: 250 mg
STORAGE: Refrigerate between 2-8°C (36-46°F).
PRESCRIBED FOR: Abatacept is used alone or in combination with other
drugs for the treatment of adult patients with moderate to severe rheumatoid
arthritis who have not adequately responded to one or more different
disease-modifying drugs (i.e., drugs that slow the destruction of joints).
Abatacept reduces the signs and symptoms of arthritis, slows the progression of
damage to the joints, and improves the physical function of patients. Abatacept
should not be combined with the disease-modifying TNF antagonists (e.g., Enbrel,
Humira and Remicade).
DOSING: Abatacept is infused
over 30 minutes. The initial dose of abatacept is
followed by additionaldoses twoand four weeksafter the first infusionwith further doses every 4 weeks
thereafter. Patients weighing < 60 kg should receive a 500 mg dose,
weighing 60-100 kg a 750 mg dose and weighing >100 kg a 1000 mg dose.
DRUG INTERACTIONS: Combining abatacept with TNF antagonists (e.g.,
Enbrel, Humira and Remicade) increases the occurrence of infections and provides
no additional relief of symptoms.
PREGNANCY: Abatacept has not
been adequately evaluated in pregnant women.
NURSING MOTHERS: Abatacept has not been adequately evaluated in women
who are nursing.
SIDE EFFECTS: The most common side effects include headache, upper
respiratory tract infections and nausea. Because abatacept depresses the immune
system it reduces the body's ability to fight infection. Therefore existing
infections may worsen or new ones may develop. Patients may also experience
infusion related reactions such as dizziness, headache, hypotension or
hypertension, nausea, wheezing, rash, nausea and shortness of breath. The most
serious side effects are infections and cancer.
Rheumatoid arthritis is an autoimmune disease that causes chronic inflammation of the joints, the tissue around the joints, as well as other organs in the body. Because it can affect multiple other organs of the body, rheumatoid arthritis is referred to as a systemic illness and is sometimes called rheumatoid disease.
You have been informed by your healthcare provider that you will need to
receive intravenous (IV) infusions of a medication to treat your health condition.
What are some of the conditions that are treated with an IV drug infusion?
Examples of conditions treated with IV infusion include: