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ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS › IMMUNOSUPPRESSANTS › IMMUNOSUPPRESSANTS › Selective immunosuppressants
abatacept
L04AA24
Forms & Strengths
- Intravenous powder for solution: 250 mg per vial
- Subcutaneous solution pre-filled syringe: 50 mg/0.4 mL
- Subcutaneous solution pre-filled syringe: 87.5 mg/0.7 mL
- Subcutaneous solution pre-filled syringe: 125 mg/1 mL
- Subcutaneous solution pre-filled click-jet autoinjector: 125 mg/1 mL
Adult Dosing
- Rheumatoid Arthritis (IV): <60 kg: 500 mg; 60-100 kg: 750 mg; >100 kg: 1 g given at weeks 0, 2, and 4, then every 4 weeks
- Rheumatoid Arthritis (SC): 125 mg once weekly (with or without an IV loading dose)
- Psoriatic Arthritis (SC): 125 mg once weekly
- Polyarticular Juvenile Idiopathic Arthritis (IV/SC): Weight-based dosing matching adult IV or 125 mg SC weekly for patients >=60 kg
Pediatric Dosing
- Polyarticular Juvenile Idiopathic Arthritis (6-17 years, IV): 10 mg/kg (for children weighing <75 kg) given at weeks 0, 2, and 4, then every 4 weeks; max 1000 mg
- Polyarticular Juvenile Idiopathic Arthritis (6-17 years, SC): 50 mg weekly (10 to <25 kg), 87.5 mg weekly (25 to <60 kg), 125 mg weekly (>=60 kg)
- Psoriatic Arthritis (>=2 years): Follow weight-based IV or SC dosing regimens similar to JIA
Indications
- Moderately to severely active rheumatoid arthritis in adults
- Active psoriatic arthritis in adults
- Moderately to severely active polyarticular juvenile idiopathic arthritis in patients 2 years of age and older
- Prophylaxis of acute graft-versus-host disease in hematopoietic stem cell transplantation (in combination with a calcineurin inhibitor and methotrexate)
Mechanism of Action
- Selective costimulation modulator
- Binds to CD80 and CD86 on antigen-presenting cells
- Blocks the CD28-mediated costimulatory signal required for full T-cell activation
- Reduces T-cell proliferation and inflammation in autoimmune diseases
Contraindications
- Hypersensitivity to abatacept or any product components
- Concurrent use with biologic disease-modifying antirheumatic drugs (bDMARDs) such as TNF antagonists
- Active serious or opportunistic infections until resolved
Adverse Reactions
- Upper respiratory tract infection
- Nasopharyngitis
- Headache
- Nausea
- Infusion-related or injection-site reactions
- Increased risk of serious infections and malignancies
Drug Interactions
- Tumor necrosis factor (TNF) antagonists: Increased risk of serious infections and no added efficacy; concurrent use contraindicated
- Live vaccines: Avoid administration concurrently or within 3 months of discontinuation
- Immunosuppressants: Potential for increased immunosuppression and infection risk
Curated Content: Needs Vetting Before Put to Clinical Use