Abatacept Dosage

Usual Adult Dose for Rheumatoid Arthritis

IV:
-Less than 60 kg, give 500 mg
-If 60 to 100 kg, give 750 mg
-If greater than 100 kg, give 1000 mg
Administer once as a 30-minute IV infusion. The dose is repeated 2 and 4 weeks after the initial dose, then every 4 weeks thereafter. It may be administered alone or with disease-modifying antirheumatic drugs other than TNF antagonists.

SUBCUTANEOUS:
-After a single IV infusion as a loading dose (as per body weight categories above), 125 mg administered by subcutaneous injection should be given within a day, followed by 125 mg subcutaneously once a week.
-Patients who are unable to receive an infusion may initiate weekly injections subcutaneously without an IV loading dose.
-Patients transitioning from IV therapy to subcutaneous administration should administer the first subcutaneous dose instead of the next scheduled IV dose.

Comments:
-This drug should not be administered concomitantly with TNF antagonists or used concomitantly with other biologic rheumatoid arthritis (RA) therapy, such as anakinra.

Use: For reducing signs and symptoms, inducing major clinical response, inhibiting the progression of structural damage, and improving physical function in adult patients with moderately to severely active rheumatoid arthritis. This drug may be used as monotherapy or concomitantly with disease-modifying antirheumatic drugs (DMARDs) other than tumor necrosis factor (TNF) antagonists.

Usual Pediatric Dose for Juvenile Idiopathic Arthritis

IV:
6 to 17 years:
If less than 75 kg, give 10 mg/kg IV
75 kg to 100 kg, give 750 mg IV
If greater than 100 kg, give 1000 mg IV
-The maximum dose per intravenous administration should not exceed 1000 mg.
-Administer once as a 30-minute IV infusion. The dose is repeated 2 and 4 weeks after the initial dose, then every 4 weeks thereafter. It may be administered alone or concomitantly with methotrexate.

SUBCUTANEOUS:
2 years and older:
The subcutaneous injection should be given without an IV loading dose:
10 kg to less than 25 kg: 50 mg subcutaneously once a week
25 kg to less than 50 kg: 87.5 mg subcutaneously once a week
50 kg or more: 125 mg subcutaneously once a week

Comments:
-This drug should not be administered concomitantly with TNF antagonists or used concomitantly with other biologic rheumatoid arthritis (RA) therapy, such as anakinra.
-The safety and efficacy of the auto-injector for subcutaneous injection has not been studied in patients under 18 years of age.

Use: For reducing signs and symptoms in pediatric patients 2 years of age and older with moderately to severely active polyarticular juvenile idiopathic arthritis. This drug may be used as monotherapy or concomitantly with methotrexate (MTX).

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Data not available

Dose Adjustments

-No dosage adjustment is recommended in geriatric patients.
-No dosage adjustment is required when this drug is used in combination with other drugs (e.g., disease-modifying antirheumatic drugs (DMARDs), corticosteroids, NSAIDs) used to treat rheumatoid arthritis.
-Patients transitioning from IV to subcutaneous therapy should administer the first subcutaneous dose instead of the next scheduled monthly IV dose.

Precautions

-Safety and efficacy of in pediatric patients below 6 years of age have not been established.
-Safety and efficacy of pediatric patients for uses other than juvenile idiopathic arthritis have not been established.
-Safety and efficacy of subcutaneous use of this drug has not been studied in patients under 18 years of age.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice:
IV infusion:
-Infuse over 30 minutes via an infusion set and a sterile, non-pyrogenic, low-protein binding filter with a pore size of 0.2 to 1.2 microns.
Subcutaneous administration:
-Subcutaneous administration is only indicated for adults.
-The first dose should be given under medical supervision. Patients can then self-inject after the treating physician is assured that the patient or caregiver's injection technique is satisfactory.
-Injection sites should be rotated and not administered into tender, bruised, red, or hard areas of skin.

Monitoring:
-When transitioning from TNF blocking agents to this drug, patients should be monitored for signs of infection.
-Patients who develop a new infection while undergoing treatment should be monitored closely and treatment discontinued if a patient develops a serious infection.
-Adult patients with rheumatoid arthritis and COPD should be monitored for worsening of respiratory status.
-Patients should be monitored for hypersensitivity reactions before and after administration.

General:
-This drug may be used as monotherapy or concomitantly with disease-modifying antirheumatic drugs (DMARDs) other than tumor necrosis factor (TNF) antagonists.