bDMARDs Quick Reference Guide

Abatacept (subcut)

Abatacept (subcut)

Active ingredient

Abatacept

Mechanism of action

T cell co-stimulation modulator

Molecule type

Fusion protein

PBS listed indications

Severe active rheumatoid arthritis

Reference product (brand)

Orencia SC

Biosimilar brands

None

Administration information

Mode of administration

Subcutaneous injection

Administration devices and strengths

Pre-filled syringe 125mg/mL

Autoinjector (Orencia Clickjet) 125mg/mL

 

A leaflet explaining how to administer the product is included in the pack.

Frequency of administration

Once a week

Storage

Store at 2-8oC (refrigerate do not freeze).

Keep pre-filled syringes and autoinjectors in the outer carton until time of use to protect from light.

Take one pre-filled syringe or autoinjector out of the fridge 30 minutes before the injection and allow it to slowly warm up to room temperature.

Standard dosing

125mg once a week

Subcutaneous therapy may be initiated with or without an IV loading dose. The IV loading dose (if given) should be based on weight and followed by the first subcutaneous injection within a day of the IV infusion.

See abatacept IV monograph for details of weight based IV dosing.

Patients switching from IV to subcutaneous therapy should administer the first subcutaneous dose instead of their next scheduled monthly IV dose.

 

Treatment with csDMARDs (e.g., methotrexate) may be continued during treatment with abatacept.

Dose variations

Patients with rheumatoid arthritis who are in remission or have low disease activity may have their dose of abatacept down-titrated by their rheumatologist.

 

Special notes

The use of abatacept in combination with other cytokine modulators (e.g. TNF-alpha inhibitors, rituximab, anakinra, tocilizumab) is not recommended due to increased risk of infection.

Abatacept is contraindicated in serious or untreated infection, e.g. sepsis, abscess, hepatitis B, active TB (before completing TB treatment).
May reactivate inactive hepatitis B and latent TB (begin TB treatment before starting abatacept).
Patients with suspected latent or active TB should be treated in consultation with an Infectious Diseases physician.

 

Live vaccines should not be given concurrently with abatacept or within 3 months of discontinuation.

References

Pharmaceutical benefits Scheme (PBS) listing. Available from https://www.pbs.gov.au/medicine/item/5605B-9621J [accessed 6/10/21]

Product information. Available from https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent&id=CP-2010-PI-03513-3 [accessed 6/10/21]

Australian Medicines Handbook 2020 (online). Adelaide: Australian Medicines Handbook Pty Ltd; 2020 July. Available from: https://amhonline.amh.net.au/  [accessed 3/5/21]

NPS Medicinewise. Down-titration strategies. Available from https://www.nps.org.au/bdmards/rheumatology-conditions/titration-strategies [accessed 3/5/21]