Orencia (abatacept) is a biological antireumatica with a new mechanism of action. The drug blocks the activation of T-lymphocytes. The indication is moderate to server rheumatoid artrit (RA) in combination with metotrexate, where another treatment, including at least one TNFα-inhibitor, had an insufficient effect or induced adverse effects.
The effect of Orencia is moderat. When it is involving RA-patients, who have not had an adequate effect of MTX or a TNFα-inhibitor, 2-3 patients must be treated before one patient will have a minimal improvement compared with placebo and there has to be treated approx 10 patients before one patient would feel/experience a significant improvement.
There are detected several adverse effects in using Orencia than placebo, primary infections. In patients above 64 years old is the risk to get adverse effects primary infections and cancer related diseases, apparently higher.
IRF states that Orencia is used so far there is an insufficient efficiency or unacceptable side effects from one of the marketed TNFα-inhibitors. You should always pursue a combination of Orencia with metotrexat. Orencia should not be given in combination with other TNFα-inhibitors.
One year of treatment with Orencia costs approx 165.000D.kr (pharmacy sale price, excl. hospital discount). That is the same price level as the TNFα-inhibitors Enbrel and Humira, but significant more expensive than Remicade in normal doses, and approx 500 times more expensive than peroral metotrexate.
Orencia was marketed 15th of June 2007. The drugs must only be handed to hospitals.