Moderate-to-severe active rheumatoid arthritis (specialist
use only) | Active psoriatic arthritis (specialist use only)
▶BY INTRAVENOUS INFUSION
▶Adult (body-weight up to 60 kg): 500 mg every 2 weeks
for 3 doses, then 500 mg every 4 weeks, review
treatment if no response within 6 months
▶Adult (body-weight 60–100 kg): 750 mg every 2 weeks for
3 doses, then 750 mg every 4 weeks, review treatment if
no response within 6 months
▶Adult (body-weight 101 kg and above): 1 g every 2 weeks
for 3 doses, then 1 g every 4 weeks, review treatment if
no response within 6 months
Moderate-to-severe active rheumatoid arthritis (specialist
use only) | Active psoriatic arthritis (specialist use only)
▶BY SUBCUTANEOUS INJECTION
▶Adult: 125 mg once weekly, review treatment if no
response within 6 months, subcutaneous dosing may
be initiated with or without an intravenous loading
dose—consult product literature
PDF page 1191
NICE decisions
▶Adalimumab, etanercept, infliximab, rituximab, and
abatacept for the treatment of rheumatoid arthritis after the
failure of a TNF inhibitor (August 2010) NICE TA195
Abatacept, in combination with methotrexate, is an option
for the treatment of severe active rheumatoid arthritis in
adults who have had an inadequate response to, or have an
intolerance of, other disease-modifying antirheumatic
drugs (DMARDs) including at least 1 tumour necrosis
factor (TNF) inhibitor, and who cannot use rituximab
because of contra-indications or intolerance. Treatment
should be continued only if there is adequate response.
Patients should be monitored at least every 6 months.
www.nice.org.uk/guidance/TA195
▶Adalimumab, etanercept, infliximab, certolizumab pegol,
golimumab, tocilizumab and abatacept for rheumatoid
arthritis not previously treated with DMARDs or after
conventional DMARDs only have failed (January 2016)
NICE TA375
Abatacept, in combination with methotrexate, is
recommended as an option for treating rheumatoid
arthritis, only if all the following criteria are met:
. disease is severe, that is, a disease activity score (DAS28)
greater than 5.1,
. disease has not responded to intensive therapy with a
combination of conventional disease-modifying
antirheumatic drugs (DMARDs),
. the manufacturers provides abatacept as agreed in the
patient access schemes.
Continue treatment only if there is a moderate response
measured using European League Against Rheumatism
(EULAR) criteria at 6 months after starting therapy. After
initial response within 6 months, withdraw treatment if a
moderate EULAR response is not maintained.
Patients currently receiving abatacept whose disease
does not meet the above criteria should have the option to
continue their treatment until they and their clinician
consider it appropriate to stop.
www.nice.org.uk/guidance/TA375
PDF page 1192
