Abatacept
Drug Info:
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Abatacept
Brand names: Orencia®
- Drug Forms:
- Abatacept (below)
- Abatacept Solution for injection
- Abatacept Solution for injection
Abatacept
What is Abatacept?
ABATACEPT (Orencia®) may be used for the treatment of rheumatoid arthritis in adults. Generic abatacept is not yet available.
What should I tell my health care provider before I take this medicine?
They need to know if you have any of these conditions:
• asthma
• blood disorders
• cancer
• chronic obstructive pulmonary disease (COPD)
• cystic fibrosis
• depressed immune system or other immune disorders
• diabetes
• emphysema
• infection
• smoke tobacco products
• tuberculosis, a positive skin test for TB, or been around someone with TB
• an unusual or allergic reaction to abatacept, other medicines, foods, dyes, or preservatives
• pregnant or trying to get pregnant
• breast-feeding
How should this medicine be used?
What drug(s) may interact with Abatacept?
• anakinra
• atropine
• etanercept
• infliximab
• medicines that decrease your immune function like cyclophosphamide, cyclosporine, and azathioprine
• scopolamine
• vaccines
Tell your prescriber or health care professional about all other medicines you are taking, including non-prescription medicines, nutritional supplements, or herbal products. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines.
What should I watch for while taking Abatacept?
Make sure to see your health care provider for follow-up on your treatment. Abatacept is often given in combination with other agents such as corticosteroids, anti-inflammatory drugs, and methotrexate to treat rheumatoid arthritis.
If you get a cold or other infection while receiving abatacept, call your prescriber or health care professional; do not treat yourself. Sinus infections are common in patients taking abatacept. Abatacept may decrease your body's ability to fight infection.
Tell your doctor or prescriber if you are going to have surgery.
What side effects may I notice from receiving Abatacept?
Side effects that you should report to your prescriber or health care professional as soon as possible:
• fever, chills, or any other sign of infection
• rash or hives
• swollen face, eyelids, lips, tongue, or throat
• trouble breathing
Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome):
• dizziness
• headache
• nausea, vomiting
• upset stomach
Where can I keep my medicine?
Abatacept is administered in a hospital or clinic setting by an appropriate healthcare professional. You will not take this medicine home.
Last updated: 12/27/2005 6:47:00 PM
Important Disclaimer: The drug information provided here is for educational purposes only. It is intended to supplement, not substitute for, the diagnosis, treatment and advice of a medical professional. This drug information does not cover all possible uses, precautions, side effects and interactions. It should not be construed to indicate that this or any drug is safe for you. Consult your medical professional for guidance before using any prescription or over the counter drugs.
Oxford A-Z of Medicinal Drugs:
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abatacept
A disease-modifying antirheumatic drug (disease-modifying antirheumatic drug) used, in combination with methotrexate, to treat moderate to severe rheumatoid arthritis that has not responded to other disease-modifying antirheumatic drugs. It works by preventing the activation of T lymphocytes (a type of white blood cell), which are involved in the immune response. Abatacept is given under expert supervision by intravenous infusion and is available on prescription only.
Side effects:
include headache, hypertension, dizziness, cough, abdominal pain, nausea, chest infections, and urinary-tract infections.
Precautions:
abatacept should not be given to people with severe infections or to women who are pregnant or breastfeeding.
Interactions with other drugs:
Anti-tumour necrosis factor drugs: should not be given with abatacept as they increase the risk of side effects.
Vaccines: should not be given to people receiving abatacept.
Proprietary preparation:
Orencia.
| abacavir, Azarga, Aveeno | |
| abciximab, acamprosate calcium, acarbose |
Wikipedia on Answers.com:
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Abatacept
| Clinical data | |
|---|---|
| Trade names | Orencia |
| AHFS/Drugs.com | monograph |
| MedlinePlus | a606016 |
| Pregnancy cat. | C (U.S.) |
| Legal status | POM (UK), ℞-only (U.S.) |
| Routes | Intravenous |
| Pharmacokinetic data | |
| Half-life | 13.1 days |
| Identifiers | |
| CAS number | 213252-14-3  |
| ATC code | L04AA24 |
| DrugBank | DB01281 |
| UNII | 7D0YB67S97  |
| KEGG | D03203 |
| ChEMBL | CHEMBL1201823 |
| Chemical data | |
| Formula | ? |
 (what is this?) (verify) |
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Abatacept (marketed as Orencia) is a fusion protein composed of the Fc region of the immunoglobulin IgG1, fused to the extracellular domain of CTLA-4, a molecule capable of binding B7. Abatacept is a selective costimulation modulator as it inhibits the costimulation of T cells. It was developed by Bristol-Myers Squibb and is licensed in the United States for the treatment of rheumatoid arthritis in the case of inadequate response to anti-TNFα therapy.
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Contents
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Mechanism of action
Abatacept prevents APCs from delivering the costimulatory signal to T cells to fully activate them. Note that binding of the activation signal without its complementary co-stimulatory signal also helps to enable downregulation of T-Cells by way of T-Cell Anergy. Simple signaling without costimulation allows the cell to recognize the primary signal as "self" and not ramp-up responses for future responses as well.
Ordinarily, full T cell activation requires 1) binding of the T cell receptor to the antigen-MHC complex on the antigen presenting cell (APC) and 2) a costimulatory signal provided by the binding of the T cell's CD28 protein to the B7 protein on the APC. Abatacept, which contains a high-affinity binding site for B7, works by binding to the B7 protein on APCs and preventing them from delivering the costimulatory signal to T cells, thus preventing the full activation of T cells.[1][2]
Derivatives
Abatacept is the basis for the second-generation belatacept currently being tested in clinical trials. They differ by only 2 amino acids. In organ transplantation, belatacept is intended to provide extended graft survival while limiting the toxicity generated by standard immune-suppressing regimens such as calcineurin inhibitors (for example ciclosporin).
Indications
Abatacept is currently approved for use in rheumatoid arthritis patients who have had an inadequate response to one or more DMARDs.[3] It is useful in delaying the progression of structural damage and reducing symptoms of rheumatoid arthritis. However, it should not be used in combination with anakinra or TNF antagonists.[4]
Clinical trials for additional indications
Abatacept had a phase III trial[5] for the treatment of patients suffering moderate to severe active ulcerative colitis, where response to standard treatment has failed to bring about remission. The trial was due to run until 2009 but after review of interim results was terminated early due to lack of efficacy.[6]
Abatacept is (As of 2008[update]) in trial[7] for the treatment of Type 1 Diabetes. In diabetic patients in the "honeymoon phase" of the disease, Abatacept may protect surviving beta cells from autoimmune attack.[citation needed]
Abatacept is currently in a phase II trial for Multiple Sclerosis in a joint Bristol Meyers and NIAID program.
The ACCESS phase II clinical trial,[8][9] sponsored by the National Institute of Allergy and Infectious Diseases is (As of 2009[update]) studying abatacept treatment in lupus nephritis when used in combination with cyclophosphamide therapy.
Abetacept in a subcutaneous administration form has been approved by USFDA, for self administration by the patient.
Structure
Abatacept is a fusion protein composed of the extracellular domain of CTLA-4 with the hinge, CH2, and CH3 domains of IgG1.[4]
Similar agents
References
- ^ "ABATACEPT & BELATACEPT: the CTLA-4-Igs". Healthvalue.net. http://www.healthvalue.net/ctlaigenglish.html. Retrieved 2007-05-25.
- ^ Dall'Era M, Davis J (2004). "CTLA4Ig: a novel inhibitor of co-stimulation". Lupus 13 (5): 372–376. doi:10.1191/0961203303lu1029oa. PMID 15230295.
- ^ Bristol-Myers Squibb (March 13, 2007). ORENCIA labelPDF (110 KiB). United States Food and Drug Administration. Retrieved on 2007-05-25.
- ^ a b Moreland L, Bate G, Kirkpatrick P (2006). "Abatacept". Nature Reviews Drug Discovery 5 (3): 185–186. doi:10.1038/nrd1989. PMID 16557658.
- ^ "A Study of Abatacept in Patients With Active Ulcerative Colitis". ClinicalTrials.gov. United States National Institutes of Health. May 11, 2007. http://clinicaltrials.gov/ct/show/NCT00410410. Retrieved 2007-05-25. ClinicalTrials.gov Identifier NCT00410410.
- ^ http://clinicaltrials.gov/ct2/show/results/NCT00410410 Ulcerative Colitis Study results
- ^ "CTLA-4 Ig (Abatacept) in Recent Onset Diabetes DEAD URL". diabetestrialnet.org. TrialNet. http://www2.diabetestrialnet.org/ctla4. Retrieved 2008-08-08. diabetestrialnet.org.
- ^ "ACCESS clinical trial for lupus nephritis". www.lupusnephritis.org. Immune Tolerance Network. http://www.lupusnephritis.org. Retrieved 2009-09-14. ClinicalTrials.gov Identifier NCT00774852
- ^ http://clinicaltrials.gov/ct/show/NCT00774852
External links
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