Generic Name: Abatacept
Brand Names: Various around the world
What is Abatacept?
Abatacept, a medication that modifies physiological processes, is utilized in the treatment of autoimmune disorders, particularly rheumatoid arthritis. Several well-established commercial preparations, such as Orencia, Orenica, and Orenosol, contain abatacept as the active ingredient. University of Chicago researchers created it in the 1990s, and it was given the all-clear to be used medicinally in 2005. This article will examine data from scientific publications and medical research on the effects, applications, and adverse effects of abatacept. These sources include Schiff’s “Abetacept treatment for rheumateid artritis” (2011) and Blair and Deeks’s “Abatacept: a review in rheumatoid arthritis” (2017).
Chemical Structure and Mechanism of Action
The extracellular domain of human CTLA-4 is fused to a modified Fc region of human IgG1 to form the soluble fusion protein known as abatacept. attaches to CD80 and CD86 on the surface of antigonopresentative cells, preventing them from interacting with T cell CD28, hence specifically suppressing T-cell co-stimulation (Blair & Deeks, 2017).
Uses
Adult patients with moderate-to-severe active rheumatoid arthritis who did not respond well to one or more DMARDs, including methotrexate, are primarily candidates for abatacept treatment. Has the potential to be utilised either alone or in conjunction with DMARDs other than TNF inhibitors (Schiff, 2011). Furthermore, studies on children six years of age and older have demonstrated the efficacy of it in the treatment of psoriatic arthritis and juvenile idiopathic arthritis. There is research being done on its use in other autoimmune diseases such systemic lupus erythematosus.
Side Effects of Abatacept
Upper respiratory infections, headaches, nausea, and injection site responses are among the most typical adverse effects. Patients on abatacept have experienced serious infections, including sepsis, pneumonia, cellulitis, and urinary tract infections; these infections have been more common when it is taken in conjunction with other immunosuppressive medications (Blair & Deeks, 2017). Anaphylaxis is one of the uncommon allergic responses that have been reported. Additionally, it may make several cancers more likely, including breast, lung, and lymphoma cancers. In individuals with severe rheumatoid arthritis, the dangers are often outweighed by the benefits of treatment, but the absolute risk is still modest.
Warnings
Patients should be screened for latent infections, such as hepatitis B and TB, before beginning abatacept treatment. Patients with immunodeficiencies or ongoing infections shouldn’t get abatacept. Throughout treatment, patients should be continuously watched for infection-related signs and symptoms. If a major infection arises, it should be stopped. In Schiff (2011). It is not advised to get live, weakened vaccines while on abatacept medication. When using abatacept with other immunosuppressive medications, caution is needed since this may raise the risk of severe infections and other adverse effects. Patients who have recurrent infections or pre-existing cancers might not be good candidates for abatacept treatment.
Precautions
When using it, individuals with a history of infections or underlying medical illnesses that might raise their risk of consequences should be closely monitored by a skilled physician. Patients should be tested for latent TB prior to beginning treatment, and during treatment, they should be closely watched for any indications of active infection (Moreland et al., 2006). Along with being aware of the possible danger of severe infections, patients should also be trained to recognise signs including fever, colds, and flu. Because there have been sporadic reports of the disease getting worse, people with pre-existing neurological conditions like multiple sclerosis must use it with caution. Given the paucity of information on the safety of abatacept during pregnancy, women of reproductive age should utilise effective contraception during treatment and for many months following the last dosage.
Contraindications
Patients who have a history of known hypersensitivity to abatacept or any of its derivatives should not use this medication. It should not be administered to patients with severe or uncontrollable infections, such as sepsis and opportunistic infections, until the illness has received proper treatment. (Deeks & Blair, 2017). Because there is a chance of infection recurrence, using abatacept in individuals with active hepatitis B or C is not advised. With the exception of non-melanoma skin cancer that has received appropriate treatment, the medication should be taken cautiously in individuals who have a history of malignancy and should be avoided in those who have received a malignant diagnosis within the last five years. Because of the higher risk of infection and other side effects, it should not be given in conjunction with other biological agents or live vaccinations.
Interactions
Combining abatacept with other immune-suppressive medications may increase the risk of infections and other adverse effects. It is not advised to use it in conjunction with other biological therapies, such as TNF inhibitors, because of the elevated risk of severe infections (Schiff, 2011). Live vaccinations should be avoided for a few weeks following the last dose and while on abatacept treatment. It is important to carefully monitor the use of abatacept in combination with immunosuppressive medications including tacrolimus, cyclosporine, and azathioprine as this may raise the risk of opportunistic infections. While methotrexate and abatacept do not appear to interact pharmacologically in a way that is clinically relevant, their combination may raise the risk of infections and should be well monitored (Blair & Deeks, 2017).
Overdose
There is little information about abatacept overdose in humans. Doses as high as 50 mg/kg have been given intravenously in clinical studies without causing dose-limiting toxicity (Moreland et al., 2006). Overdosing, however, may make infections and other negative effects more likely. It is advised to closely monitor the patient in the event of an overdose for any indications of adverse reactions and to administer the proper symptomatic treatment. Although hemodialysis or hemodialyse may be helpful in situations of severe overdosage, there is no particular treatment for abatacept overdose. The attending physician’s clinical judgement and the patient’s state should be taken into consideration when deciding whether to administer these interventions.
Briefly
A biological medication called abatacept is used to treat autoimmune diseases such juvenile idiopathic arthritis, psoriatic arthritis, and rheumatoid arthritis. It works by specifically preventing T-cell co-stimulation, which lowers joint injury and inflammation. It is typically used in combination with other disease-modifying antirheumatic medications (DMARDs), such as methotrexate, and is given intravenously or subcutaneously. It may raise the risk of infections, especially severe infections like pneumonia and sepsis, while being typically well tolerated. Headache, nausea, and allergic responses are a few other potential adverse effects. When using abatacept, patients with a history of infections or cancer should be carefully chosen and closely monitored by a medical professional with experience. Avoiding interactions with live vaccinations and other immunosuppressive medications. All things considered, people with severe rheumatoid arthritis and other autoimmune diseases who do not react well to standard therapies may find that abatacept is a useful treatment alternative.
WARNING: It is imperative that you never take medicine without a doctor’s supervision and instruction. Please refer to the insert included on the packaging of any prescription medication, since each pharmaceutical business correctly outlines the product’s precise specifications—which might be updated on a frequent basis. Please be aware that the trade names included in this article refer to well-known medications that contain the active ingredients being examined. Nevertheless, there could be differences based on how each medication is made. This article does not discuss the trade name of the medication; instead, it analyses the active ingredient. The only purpose of including trade names is for readers’ convenience; they should carefully read the directions included with any commercial preparation they use. It’s necessary to work closely with your doctor and chemist. Any pharmaceutical self-administration has significant health hazards and must to be completely avoided.
Bibliography
- Blair, H. A., & Deeks, E. D. (2017). Abatacept: a review in rheumatoid arthritis. Drugs, 77(11), 1221-1233. link.springer
- Moreland, L., Bate, G., & Kirkpatrick, P. (2006). Abatacept. Nature Reviews Drug Discovery, 5(3), 185-186. ebscohost
- Schiff, M. (2011). Abatacept treatment for rheumatoid arthritis. Rheumatology, 50(3), 437-449. academic.oup
