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Orencia (Abatacept)

Orencia is biologically engineered medicine that can slow the progression of RA in adults, including people who have not responded well to other treatments. In clinical studies, Orencia was able to slow the pain, swelling, and loss of function typically caused by RA. This medication can be used alone or with other medications.1

Orencia works by blocking certain cells in the immune system, so it is known as an immunomodulator, and more specifically, a costimulation modulator. It is also approved for treating adult psoriatic arthritis and juvenile idiopathic arthritis.1,2

Orencia is not available in generic forms.

What are the ingredients in Orencia?

The active ingredient in Orencia is abatacept.3

How does Orencia work?

Orencia is an engineered (biologic) DMARD (disease-modifying antirheumatic drug) that operates early in the chain of events that lead to the swelling and joint damage characteristic of RA. It works by blocking certain proteins important in the process of T-cell activation. Activated T-cells signal other factors in the immune system to generate swelling. By stopping the T-cells from becoming activated in the first place, Orencia reduces the number of inflammation signals in the body.4

What are the possible side effects of Orencia?

Common side effects with Orencia include:1,5

  • Headache
  • Nausea
  • Infections
  • Runny nose
  • Sore throat

Infusion-related reactions, including:

  • Flu-like symptoms
  • Headache
  • Shortness of breath
  • Low blood pressure
  • Fever and chills
  • Stomach symptoms
  • Skin rash
  • Allergy

In some patients, Orencia can cause more harmful side effects. Patients who take Orencia are at increased risk for serious infections, including tuberculosis, reactivation of hepatitis, pneumonia, and urinary tract infections. It can also cause inaccurate glucose readings in patients with diabetes.5

This is not an exhaustive list of all potential side effects of Orencia. For more information, consult your doctor or healthcare provider. If you notice any new or worsening side effects, contact your doctor or healthcare provider immediately.

Things to note about Orencia

Before taking Orencia, tell your doctor if you1,5:

  • Have a current infection or are prone to recurring infections, including open cuts
  • Have HIV, diabetes, or a weakened immune system
  • Have tested positive for TB or have been in close contact with someone who has TB
  • Have or have had Hepatitis B
  • Have COPD, or chronic obstructive pulmonary disease
  • Are scheduled to receive a vaccine
  • Are pregnant or plan to become pregnant or are breastfeeding

With Orencia, there is an increased risk for serious infection. This is because Orencia can decrease the ability of the immune system to fight infections. If an infection develops while you are taking this medication, or if you have a severe allergic reaction, contact your doctor immediately. You may need to stop the medication.1

Patients taking this medication should not receive live vaccines during treatment or 3 months after. Patients with COPD should be cautious when taking Orencia because it can increase your difficulty breathing and make your symptoms worse. Tell your doctor about any medications or supplements you are taking while on Orencia, because it doesn’t mix well with certain medicines, especially other biologics approved to treat RA. Do not take Orencia if you are currently taking anti-TNF medications, because it increases your risk of developing serious infections. It is important for doctors to test you for TB before you take Orencia.1,5

Dosing information

Orencia is given either through a vein in your arm via intravenous (IV) infusion or as an injection under the skin. Infusions of Orencia must be given in a medical office, and they take about 30 minutes to complete. The infusion dose is based on body weight. Treatments are given at weeks 0, 2, and 4 and then continued monthly.1

If Orencia is taken as a subcutaneous injection, treatment may be started with or without an initial IV “loading” dose. If you have an IV loading dose, then you should follow that within a day with an injection of 125 mg of Orencia. After that, you will take your injection weekly. If you start Orencia without the initial IV loading dose, then you will take weekly Orencia injections. The medicine comes in prefilled syringes of 125 mg each.1

If you decide to give yourself Orencia injections at home, you (or a caregiver) should receive training on the correct way to prepare and administer the injection. Call your doctor if you have questions.1

Written by: Sara Finkelstein | Last reviewed: September 2019.
  1. Abatacept Injection. MedlinePlus. National Library of Medicine, National Institutes of Health. Bethesda, MD. Revised February 11, 2012. Accessed June 11, 2018.
  2. The Science Behind Orencia (abatacept). Bristol-Myers Squibb Company. Princeton, NJ. Revised March 2017. Accessed June 11, 2018.
  3. Prescribing Information. Bristol-Myers Squibb Company. Princeton, NJ. Revised March 2017. Accessed June 9, 2018.
  4. Carolina Negrei, Violeta Bojinca, Andra Balanescu, et al. Management of rheumatoid arthritis: Impact and risks of various therapeutic approaches. Exp Ther Med. 2016 Apr; 11(4): 1177–1183. Published online 2016 Feb 2. doi: 10.3892/etm.2016.3045 Accessed June 11, 2018.
  5. Abatacept (Orencia). American College of Rheumatology. Updated March 2018. Accessed June 11, 2018.