Abatacept(Orencia)

商业名称Abatacept是一种称为生物疗法的药物。它针对炎症的原因，并减少免疫系统的活性。对于许多关节炎患者来说，这是一种有效的治疗方法。

Abataceptcan be prescribed by a consultant rheumatologist for:

• 类风湿关节炎(roo-ma-toyd arth-ri-tus)
• polyarticular juvenile idiopathic arthritis (poly-ar-tic-ular joo-ver-nile arth-ri-tus)
• psoriatic arthritis(saw-ree-atik arth-ri-tus).

通常，免疫系统会产生炎症以保护人体免受感染。但是在某些情况下，免疫系统中的一组细胞（称为T细胞）会导致不必要的炎症会损害人体健康组织。

Abataceptworks by reducing the activity of these T-cells, which in turn reduces inflammation, pain, swelling and joint damage. 

如果您至少没有尝试过，通常不会接受生物疗法疾病改良的抗毒药(DMARDs), such asmethotrexate，，，，sulfasalazineorleflunomide。

Abataceptcan be the first biological therapy you get prescribed, but more commonly you will have tried others first.

Abataceptis a very effective therapy for many people with arthritis. However, there are certain people who may not be able to take it.

Before you’re prescribed abatacept, doctors sometimes use a scoring system to work out how active your arthritis is. The system can be different depending on what condition you have, but most often you’ll be asked how well you feel on a scale of 1 to 10 and your doctor will make a note of how many of your joints are tender and swollen.

You’ll also need blood tests before treatment starts to assess your condition and whether the drug is suitable for you.

Your doctor might not prescribe abatacept if:

• you’re pregnant or breastfeeding
• 您目前正在服用另一种生物药
• you have HIV
• 您患有癌症。

如果您有反复来来去去的感染，则应谨慎使用该药物。

你的医生如果你previousl需要检查y been exposed to tuberculosis (TB). If the tests are positive you may need to start a course of treatment for TB before starting abatacept.

如果你有肝炎B或C,你可能需要regular checks for this, as abatacept may increase the risk of the hepatitis starting up again.

可以给出Abatacept：

• 通过滴入静脉，被称为静脉输注。您将在医院或诊所中一个月有一个。它需要一个和两个小时。
• as an injection under the skin once a week using a pre-filled syringe or pen. This is known as a subcutaneous injection. You, your partner, or another family member can learn to give these injections at home.

Speak to yourrheumatology team如果您已经通过输液进行了Abatacept，并希望切换到注射剂 - 您可能会在下一次输注时开始注射。

如果您忘记在三天内服用剂量，只需记住并继续按照您的时间表服用剂量时就服用。如果您服用剂量迟到了三天以上，请询问您的风湿病团队何时服用下一个。

It’s a long-term treatment and may not work right away. Some patients report it took between 6–12 weeks before they started to feel better. So, it’s important to continue taking this drug as prescribed, even if you don’t feel better right away. You should also continue taking it when your symptoms improve, and you start to feel better, to help keep your condition under control.

大多数人没有经历副作用。在输注或注射时可能会发生一些副作用。它们通常不是严重的，但是如果您有严重的副作用或担心自己的症状，请与一位负责您护理的医疗保健专业人员联系。

一些副作用可能包括：

• 头晕
• tiredness
• headaches
• 感到恶心或呕吐
• diarrhoea.

在极少数情况下，人们可能会对Abatacept过敏。这可能是以肿胀或皮疹的形式，或者您可能会感到呼吸。这是非常罕见的，但是如果您确实会出现这些症状或任何其他严重症状，则在剂量的Abatacept后不久，您应该立即寻求医疗建议。

由于Abatacept会影响您的免疫系统，因此您可能更有可能接收感染。最常见的是轻度胸部和尿液感染。

如果您出现任何症状，例如不会消失的咳嗽，无法解释的减肥或发烧，请立即告诉您的医生或风湿病护士。如果您有这些症状，则还应该在注入或注射之前告诉风湿病团队。他们可能建议您暂停治疗。

如果您有水痘或带状疱疹，或者与患有水痘或带状疱疹的人接触，并且您以前从未有过水痘，则应联系医生。如果您要服用Abatacept，这些疾病可能会比平常更糟。您可能需要抗病毒治疗，并且可能会停止使用，直到您改善为止。

服用Abatacept时，您可能需要定期进行血液检查。

减少感染风险的提示

• 尽量避免与您认识的感染者密切接触。
• 定期洗手，携带一小瓶抗菌手凝胶。
• Keep your mouth clean by brushing your teeth regularly.
• Stop smoking if you’re a smoker.
• Make sure your food is stored and prepared properly.
• 尝试保持房屋清洁和卫生，尤其是厨房，浴室和厕所。

建议您携带一张生物疗法警报卡，以便任何人都知道您在Abatacept上。向您的风湿病团队咨询卡。

如果您要参加Abatacept，您可能会服用methotrexateas well. Check with your doctor before starting any new medicines, and if you’re treated by anyone other than your usual rheumatology team, tell them you’re taking abatacept, as it won’t appear in your repeat prescription list from your GP.

你可以继续非甾体类抗炎药（NSAIDS），，，，such as ibuprofen, orpainkillers，，，，such as paracetamol if needed, unless your doctor advises otherwise.

不要首先与您的风湿病团队讨论过非处方药或草药疗法，因为有些人可能会对Abatacept做出不良反应。

Vaccinations

It’s usually recommended that people on abatacept avoid live vaccines such as measles, mumps and rubella (MMR), chickenpox and yellow fever. But sometimes a live vaccine may be necessary, so you should discuss this with your rheumatology team.

如果您从未有水痘，最好在开始Abatacept之前对其进行疫苗接种。但是，请与YourRheumatology Teamfirst讨论。

It’s also a good idea to get any family or household members vaccinated against chickenpox before you start taking abatacept.

The Zostavax shingles vaccine is a live vaccine and isn’t recommended for people who are on abatacept. However, a non-live shingles vaccine (Shingrix) is available so you may be able to have this instead.

It’s recommended that you have the vaccination against COVID-19. It’s recommended that you have the pneumonia vaccine and yearly flu vaccine injection while taking abatacept. These vaccines are not live, so it’s safe for you to have them.

If you’re unsure about whether you should be having a vaccine, you should mention this to your doctor or a healthcare professional. They should be able to give you the best advice.

有操作

Talk this over with your specialists. It’s likely you will be advised to stop abatacept for a few weeks before and after your surgery.

There’s no known interaction between abatacept and alcohol, so it’s fine to have a drink if you’re taking this medication.

政府指南表示，男女每周的酒精都不得超过14单位。在整个星期的过程中，您应该尝试将它们均匀地散布。这相当于大约六杯酒或六品脱啤酒。

You can find out more about units of alcohol atwww.drinkaware.co.uk。

如果您打算尝试婴儿，如果您怀孕或考虑母乳喂养，请与您的联系风湿病学家。

除非必不可少，否则应避免在怀孕期间避免阿atacept，因为尚不知道阿atacept如何影响未出生的婴儿。

However, if you accidently take abatacept in the first three months of pregnancy it is unlikely to be harmful. If this happens to you, talk to your rheumatology team as soon as you can.

Recent guidelines now state that you can breastfeed while taking abatacept.

There is currently no evidence that men must stop abatacept if they are trying to father a baby.