The Medical Letter on Drugs and Therapeutics
Abatacept (Orencia) for Rheumatoid Arthritis
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Abatacept (Orencia – Bristol-Myers Squibb), an inhibitor of T-cell activation, has been approved by the FDA for treatment of moderate to severe rheumatoid arthritis (RA) in patients who have not responded to one or more disease-modifying anti-rheumatic drugs (DMARDs).

STANDARD TREATMENT — To prevent irreversible damage to joints, DMARDs are now used early in the treatment of RA.1 Methotrexate is generally the DMARD of choice. The tumor necrosis factor (TNF) inhibitors (etanercept, infliximab and adalimumab) appear to be more effective than methotrexate and other DMARDs in halting joint destruction and are being used as first-line therapy for some patients, even though their long-term safety remains unclear. In patients who do not respond adequately to single agents, combinations are often effective, especially methotrexate plus a TNF inhibitor.

MECHANISM OF ACTION — ... more      

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Title: Abatacept (Orencia) for Rheumatoid Arthritis
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