Trade Name(s):

Orencia

Available

In 250 mg vials

Dose

Orencia is given at a dose based on body weight, roughly 10 mg/kg. Typically, a dose of 500 mg is given to a patient weighing 132 lbs. or less, 750 mg to an individual weighing between 132 and 200 lbs., and 1 gram to anyone over 200 lbs. Infusions are given every 30 days after three initial loading doses, each given two weeks apart.

Indications

Orencia is indicated for the treatment of rheumatoid arthritis after failing at least one other DMARD or TNF inhibitor.

Side Effects

The most common reported side effects include headache, upper respiratory infection, and nausea. Infusion reactions, while uncommon, may be accompanied by dizziness, high blood pressure, cough, shortness of breath, or headache. Caution should be used in patients with a history of chronic obstructive pulmonary disease (COPD or emphysema) and those with a history of frequent infections.

Monitoring

As with patients taking other biologic response modifiers, a blood count is typically drawn at least every 6 months. Most individuals will be taking other disease modifying drugs that will require other blood work to be done routinely to monitor for safety. Screening patients in advance for TB and hepatitis is recommended.

Important Points to Know

This medication appears to be associated with a smaller risk of infection than what is seen with TNF antagonists. Still, it is recommended that Oeancia not be utilized with TNF antagonist therapy, as studies have shown increased infection risk but no significant additional benefit when these drugs are combined. Maximal responses to this drug may not be seen for three to six months.

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