Abatacept (IV)

Severe active rheumatoid arthritis

None

IV administration utilises weight-range based dosing.

Initial administration followed by doses at weeks 2 and 4 after first infusion then every 4 weeks.

IV infusion is given over 30 minutes.

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

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

• 10mg/kg infusion per month reducing to 5mg/kg infusion per month

Monitor for anaphylaxis and infusion reactions during and after the infusion. Infusion reactions including dizziness, nausea, flushing and hypotension can occur within one hour of infusion and up to 24 hours after infusion.

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.