abatacept at a glance
Medicine class
Selective immunosuppressant and biological disease-modifying treatment.
Licensed uses
Rheumatoid arthritis, psoriatic arthritis and polyarticular juvenile idiopathic arthritis in defined circumstances.
How it is given
By injection under the skin or intravenous infusion, depending on the product and patient.
Key precaution
It can reduce resistance to infection; screening and infection review are important before and during treatment.
What is abatacept used for?
The selected UK products are licensed for:
Moderate to severe active rheumatoid arthritis in adults after an inadequate response to specified disease-modifying treatments, or highly active progressive rheumatoid arthritis in adults not previously treated with methotrexate; licensed use is with methotrexate.
Active psoriatic arthritis in adults after an inadequate response to previous disease-modifying treatment, where additional systemic treatment for skin psoriasis is not required; it may be used alone or with methotrexate.
Moderate to severe active polyarticular juvenile idiopathic arthritis after an inadequate response to previous disease-modifying treatment. The licensed minimum age and available route differ between the subcutaneous syringe and intravenous product; use may be alone if methotrexate is unsuitable or not tolerated.
How does abatacept work?
Full T-cell activation needs a costimulatory signal involving CD80 or CD86 on antigen-presenting cells and CD28 on T cells. Abatacept binds CD80 and CD86, interrupting this signal and reducing T-cell-driven cytokine production, antibody responses and inflammation.
abatacept preparations and strengths
Solution for infusion
Route: Intravenous
Strengths: 250 mg
Injection
Route: Parenteral
Strengths: 50 mg, 87.5 mg, 125 mg
How to take abatacept
Abatacept is not taken by mouth, so food does not affect administration. Intravenous treatment is prepared and given by healthcare professionals. A patient or caregiver may use the pre-filled syringe after training and approval from the clinical team.
For subcutaneous injection, rotate injection sites and avoid skin that is tender, bruised, red or hard.
Keep pre-filled syringes refrigerated, protected from light and never frozen.
Before injection, allow the syringe to reach room temperature as directed in the package instructions; do not shake it.
Each pre-filled syringe is for single use. Follow the supplied instructions and local sharps-disposal arrangements.
abatacept side effects
Common or expected effects
- Upper respiratory infections, such as colds or sinusitis
- Headache or dizziness
- Nausea, abdominal discomfort, diarrhoea or indigestion
- Cough
- Rash
- Tiredness or weakness
- Injection-site reactions with the subcutaneous product
- Abnormal liver blood-test results
Get urgent medical advice
- Serious infection, including pneumonia, sepsis or opportunistic infection
- Severe allergic or anaphylactic reaction
- New or worsening neurological, psychiatric or cognitive symptoms that could indicate progressive multifocal leukoencephalopathy
- Worsening breathing problems, particularly in someone with chronic obstructive pulmonary disease
abatacept in pregnancy
Human pregnancy evidence remains limited. UK product information advises that abatacept should be used only when the pregnant person's clinical condition requires it. UK rheumatology guidance reports no clear teratogenic signal but generally advises considering stopping at conception, with use reserved for severe disease when suitable alternatives are unavailable. Discuss pregnancy plans or an unplanned pregnancy promptly with the specialist team. Exposure later in pregnancy may affect when the baby can receive live vaccines.
abatacept while breastfeeding
Advice differs because evidence is limited. UK product information advises stopping breastfeeding during treatment and for a period afterwards, while British Society for Rheumatology guidance considers breastmilk exposure compatible on limited evidence. A specialist assessment should balance disease control, product information, infant age and health, and alternative treatments.
abatacept interactions
Tell the specialist team about all prescribed, non-prescribed and complementary treatments and planned vaccinations.
TNF inhibitors
Concurrent use is not recommended because clinical trials found more overall and serious infections.
Other biological immunosuppressants or immunomodulators
Combined immune suppression may increase infection or other immune-related risks; evidence is insufficient for combinations such as anakinra or rituximab.
Common questions about abatacept
Answers are fully visible for fast scanning and source review.
Is abatacept a biologic or an immunosuppressant?
It is both: a biological disease-modifying treatment and a selective immunosuppressant that reduces T-cell activation.
What conditions is abatacept licensed to treat in the UK?
Selected products are licensed for defined cases of rheumatoid arthritis, psoriatic arthritis and polyarticular juvenile idiopathic arthritis.
Can abatacept be self-injected?
The pre-filled syringe may be used by a patient or caregiver after appropriate training and approval from a healthcare professional. Intravenous abatacept is given by a clinical team.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.