Abatacept (Orencia®), the first T-lymphocyte co-stimulation modulator, for use in rheumatoid arthritis

Abatacept (Orencia, Bristol-Myers Squibb) is the first T-lymphocyte co-stimulation modulator to be approved by FDA, The agent is indicated for use in patients with moderate-to-severe, active rheumatoid arthritis who have not had an adequate response to methotrexate, tumor necrosis factor (TNF) inhibitors, or other disease-modifying anti-rheumatic drugs (DMARDs). Abatacept inhibits the immune and inflammatory response by blocking the activation of helper T-cells. Abatacept 10 mg/kg intravenously at Weeks 0,2, and 4, and then every 4 weeks thereafter, decreases inflammation and pain in 2 to 4 weeks. The agent may be used as the only DMARD or in combination with other DMARDs except TNF-alpha inhibitors. The most common adverse effects associated with abatacept are headache, upper respiratory symptoms or infection, and gastrointestinal disturbance. (Formulary. 2006;41:322-326.