Orencia (Abatacept) for Psoriatic Arthritis

What Members Say Top Tips Side Effects Copay Help FAQs

Orencia (abatacept) is a prescription medication approved by the U.S. Food and Drug Administration (FDA) to treat people ages 2 and older with active psoriatic arthritis.

What Members Say

MHT logo These insights are based on 180 comments about Orencia from MyPsoriasisTeam members. These are the experiences of a small number of people and are not meant to be medical advice.

Benefits:

Joint pain, swelling, and stiffness sometimes improve with weekly injections or monthly infusions.
Relief sometimes begins within weeks, though fuller benefits may take longer.
Long-term control is possible, with some members staying on Orencia for years.

Considerations:

Full benefits can take time, and several comments mention waiting months for improvement.
Infections are an important risk, and treatment interruptions can happen when infections develop.
Infusion scheduling, travel, insurance approval, and injection-device use can add to the treatment burden.

How Orencia Works and How It’s Taken

Orencia is a selective T-cell costimulation modulator. It blocks signals needed to fully activate T cells, which are immune cells involved in psoriatic arthritis.

In psoriatic arthritis, this may help reduce immune system activity and inflammation that can drive joint symptoms.

Doctors prescribe Orencia when psoriatic arthritis is active in people ages 2 and older.

Adults can receive Orencia as an injection under the skin or as an intravenous (IV) infusion into a vein. Children with psoriatic arthritis receive Orencia only as an injection under the skin.

With proper training, a person or caregiver may give the injection at home if a healthcare professional decides this is appropriate.

Typical Dosing for Psoriatic Arthritis

Adults receive 125 milligrams by injection under the skin once weekly. No IV loading dose is needed.

Children ages 2 and older receive a once-weekly injection under the skin based on body weight:

10 kilograms to less than 25 kilograms — 50 milligrams
25 kilograms to less than 50 kilograms — 87.5 milligrams
50 kilograms or more — 125 milligrams

Adults receiving Orencia by IV infusion are given the medicine over 30 minutes. The dose is given at the start of treatment, at weeks 2 and 4, and then every 4 weeks:

Less than 60 kilograms — 500 milligrams
60 kilograms to 100 kilograms — 750 milligrams
More than 100 kilograms — 1,000 milligrams

This information is based on prescribing information, but your healthcare provider may tailor your treatment plan. Always follow their guidance.

Top Advice From Members on Orencia

MHT logo These insights are based on 180 comments about Orencia from MyPsoriasisTeam members.

Members who use Orencia often say it helps to stay in close touch with their rheumatologist, especially during the first few months. Many also mention watching for side effects, infections, or changes in symptoms and giving the medication some time to work before deciding how well it is helping.

1

Be patient because results may take time.
“They tell me it might take up to three months before I start to notice any change — really starting to see some results.”
2

Tell your care team promptly about infections or illness.
“I’m on Orencia weekly injections — I have to keep stopping because I keep getting infections.”
3

Ask for help with the injection device or infusion schedule.
“I had an Orencia injection pen I had a really hard time figuring out, but I finally got it — so hard to push down to get the needle to inject!”

Connect with others who understand life with psoriatic arthritis. Join MyPsoriasisTeam for free.

Orencia Side Effects

In clinical studies of Orencia, the most common side effects included:

Headache
Upper respiratory tract infection (such as a cold)
Nasopharyngitis (coldlike symptoms, sometimes called a “head cold”)
Nausea

Serious Side Effects and Warnings

Orencia can cause serious side effects that may require immediate medical attention. These include:

Serious infections — Pneumonia, sepsis, and other severe infections can occur.
Hypersensitivity reactions — Anaphylaxis and angioedema can occur and may cause swelling of the face, lips, tongue, or throat.
Hepatitis B reactivation — The virus can become active again in people who carry the hepatitis B virus.

Get medical help right away if you think you are having a serious reaction.

How To Save on Orencia

Bristol Myers Squibb, the manufacturer of Orencia, offers the ORENCIA On Call Patient Support Program and Savings Card. Eligible people with commercial insurance may pay as little as $5 per month.

The ORENCIA On Call program also offers help understanding insurance coverage, support from Care Counselors, and access to trained nurses who can answer questions about treatment and how to inject Orencia.

To learn more, visit the Orencia support and savings page or call 800-673-6242.

What To Know Before Taking Orencia

Before starting Orencia, your doctor will test you for latent (hidden) tuberculosis (TB) and screen you for viral hepatitis.

Make sure your vaccines are up to date before treatment. Do not receive live vaccines while using Orencia or for three months after stopping it. Orencia may make some vaccines work less well.

Do not take Orencia if you are allergic to abatacept or any ingredient in Orencia.

Tell your doctor about all medicines you take, including prescription drugs, over-the-counter medicines, vitamins, and herbal supplements.

Before starting Orencia, tell your healthcare provider if you:

Have an infection, including a small cut or sore, the flu, or an infection that keeps coming back
Have had viral hepatitis
Have had TB, tested positive for TB, or been close to someone with TB
Have chronic obstructive pulmonary disease (COPD)
Are scheduled for surgery
Recently received a vaccine or are scheduled to receive one
Have a personal or family history of skin cancer or notice new skin growths or changes
Have diabetes and use a blood glucose monitor
Have a history of Epstein-Barr virus (EBV) or cytomegalovirus (CMV)

IV Orencia contains maltose, which can cause falsely high blood sugar readings with some monitors on the day of an infusion. Subcutaneous Orencia does not contain maltose.

Especially tell your healthcare provider if you take other biologic medicines that affect the immune system, including etanercept (Enbrel), adalimumab (Humira), infliximab (Remicade), anakinra (Kineret), rituximab (Rituxan), certolizumab pegol (Cimzia), tocilizumab (Actemra), or golimumab (Simponi).

Using Orencia with tumor necrosis factor (TNF) blockers, other biologic medicines for rheumatoid arthritis or psoriatic arthritis, or Janus kinase (JAK) inhibitors is not recommended.

Orencia is also FDA-approved to treat rheumatoid arthritis and polyarticular juvenile idiopathic arthritis and to help prevent acute graft-versus-host disease.

Tell your healthcare provider if you are pregnant, plan to become pregnant, or are breastfeeding. The available information is not enough to determine the risks of Orencia during pregnancy, and it is not known whether Orencia passes into breast milk.

Community FAQs

These answers are fact-checked by our editorial staff.

How effective is Orencia for psoriatic arthritis?

In a study of adults with psoriatic arthritis, 47.5 percent of people who received weight-based intravenous Orencia had an ACR 20 response at week 24. This means they had at least a 20 percent improvement in key signs and symptoms of the disease. In comparison, 19.0 percent of people who received placebo (an inactive treatment) had this response.

In another study, 39.4 percent of people who received 125 milligrams of Orencia under the skin once weekly had an ACR 20 response at week 24. This compared with 22.3 percent of people who received placebo.

These results show that Orencia helped some people with psoriatic arthritis, but not everyone responded.

Should I take Orencia for psoriatic arthritis if I have an infection?

Tell your doctor if you have an infection before starting Orencia. This includes an infection that keeps coming back, does not go away, or is limited to one area of the body.

Serious infections have been reported with Orencia. Before treatment, your healthcare provider should screen you for latent tuberculosis and viral hepatitis. If you develop a serious infection while taking Orencia, treatment should be stopped.

Using Orencia with TNF blockers, other biologic medicines for psoriatic arthritis, or JAK inhibitors is not recommended because it may increase the risk of infection.