New Biologic Available Orencia (abatacept) from Arthritis Today

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New Biologic Available?

Arthritis Today, MARCH-APRIL 2006

Q: I just heard that a new biologic has been approved for RA. Would

it be worth switching from Enbrel?

A: The new biologic you heard about is abatacept (Orencia). Although

it is the fifth biologic agent to be approved for RA, it is the first

in a new subset of biologics known as co-stimulation blockers.

Unlike the other biologics – which work by blocking interleukin-1

(IL-1) or tumor necrosis factor-alpha (TNF-a) – Orencia works by

shutting off a signal that activates T cells, key components of the

inflammatory process.

Because Orencia works differently and earlier in the inflammation

process than the other biologics, it has proven effective for many

people whose RA has not responded to those agents. In fact, Orencia

is approved specifically for people for whom disease-modifying anti-

rheumatic drugs (DMARDs) or TNF-a-blocking biologics have not been

effective.

Orencia is administered in a series of 30-minute infusions in a

doctor’s office or infusion center. It can be given alone or with a

DMARD such as methotrexate. It cannot, however, be taken with other

biologic agents, because the combination could greatly increase the

risk of serious infections. Otherwise, the potential side effects of

Orencia are similar to those of the TNF-a inhibitors, such as

adalimumab (Humira), etanercept (Enbrel) and infliximab (Remicade),

and include an allergic-type skin reaction at the infusion site and

increased risk of infection or lymphoma.

I can’t say if you should switch to Orencia, but it would be worth

mentioning to your doctor.

LESLIE CROFFORD, MD

Rheumatologis

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