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What Is Orencia and How Does It Work?

Orencia is a medication with the generic name abatacept. It was first approved by the FDA on December 23, 2005, for reducing signs and symptoms of rheumatoid arthritis. It is also used to slow the progression of structural damage and improve the physical function in adult patients with moderately to severely active rheumatoid arthritis who have had an inadequate response to one or more Disease-Modifying Anti-Rheumatoid Drugs (DMARDs), such as methotrexate. Orencia may be used as a monotherapy or concomitantly with DMARDs (other than a class of medications known as TNF antagonists).

Orencia is a selective T-Cell co-stimulation blocker, and it exhibits its therapeutic action through the inhibition of T-cells (T-lymphocyte activation). T-cells are a type of white blood cell that is mainly responsible for inflammation when the immune system attacks its own tissues, including joints, and is typically found in the synovium (the connective tissue that lines the inside of the joint capsule) of patients with rheumatoid arthritis.

Orencia Dosing Information

Orencia comes in three forms: As a solution for intravenous infusion, as a solution auto-injector for subcutaneous self-injection, and lastly as a prefilled syringe for subcutaneous injection.

1. Intravenous dosing and administration (for rheumatoid arthritis and psoriatic arthritis):

Depending on body weight, the dose of Orencia is calculated as follows:

• Patients under 60 kg: 500 mg
• Patients between 60 to 100 kg: 750 mg
• Patients over 100 kg: 1,000 mg

The dose is diluted in normal saline and is then infused through a catheter that gets inserted into the vein of the arm. Infusions usually take about 30 minutes followed by a period of observation for any infusion-related reactions.

2. Intravenous dosing and administration (for acute graft-versus-host disease, prophylaxis):

Depending on body weight, the dose of Orencia is calculated as follows:

10 mg/kg (maximum 1,000 mg/dose) on the day prior to transplantation followed by 10 mg/kg (maximum 1,000 mg/dose) on days 5, 14, and 28 post-transplantation.
3. Subcutaneous dosing (for rheumatoid arthritis and psoriatic arthritis only):

The dose is 125 mg injected subcutaneously once weekly (either self-injected by the patient using the auto-injector form or injected by your doctor using the pre-filled syringe form).

Before starting therapy on Orencia, your doctor should screen you for tuberculosis and hepatitis, as taking Orencia may cause a latent infection activation for either of those infections.