Orencia (abatacept)
How this therapy is used at Arthritis Care of Texas in Corpus Christi, TX — what it is, how it is taken, side effects, and safety checks.
- Treats
- Rheumatoid arthritis · Psoriatic arthritis
- How given
- IV infusion in our office, or self-injection at home
- How often
- Monthly infusion, or weekly injection
Orencia does both jobs: it eases pain and swelling and helps protect joints from damage. It is a long-term controller, not a painkiller — benefits may take 6–12 weeks to appear, so keep taking it even before you feel the difference, and even after you improve.
What it is: A biological therapy that interferes with the function of T-cells in the immune system, modifying the inflammation and immune activity that cause rheumatoid arthritis symptoms. It is a long-term treatment — benefits may take 6–12 weeks to appear. It may be the first biologic tried, or used after others such as an anti-TNF drug or rituximab. It is almost always used in combination with methotrexate.
Before starting: It is not started if your arthritis isn't active or fewer than two DMARDs (such as methotrexate, sulfasalazine, or leflunomide) have been tried. It may not be prescribed if you are pregnant or breastfeeding, have an infection, are on an anti-TNF drug, have had repeated infections, or have had cancer. Blood tests are done before starting, along with a TB exposure check — latent TB may need treatment first — and monitoring for hepatitis reactivation.
How it's taken: Either an intravenous infusion (1–2 hours, once a month, in our office or a special clinic) or a weekly injection under the skin at home with a pre-filled syringe or pen. If you are more than three days late on a dose, ask the rheumatology team when to take the next one. Keep taking it long-term, even if it doesn't seem to work at first, and even when your symptoms improve.
Side effects: Most common around infusion or injection time: dizziness, headaches, and nausea — usually not serious. There is a higher infection risk (most common: chest and urinary infections, rhinitis, conjunctivitis), and infections can be harder to spot — report a sore throat, fever, persistent cough, or weight loss promptly. Chickenpox and shingles can be severe and may need antivirals and pausing treatment. A rare allergic reaction (sudden swelling, rash, breathlessness) needs immediate medical advice. There may be a slightly increased cancer risk, which research has not confirmed.
Pregnancy: Discuss with your rheumatologist. The effect on the unborn baby is unknown; abatacept doesn't cross the placenta until 16 weeks, so it is unlikely to be harmful in the first three months, but contraception is advised while on it and for three months after stopping. Breastfeeding is not recommended.
Why the checks: Each check has a purpose: the TB test looks for a hidden infection that immune-calming treatment could wake up, so it can be treated first; blood tests give a baseline for liver and infection markers, so any later change is easy to spot; and the hepatitis check matters because past hepatitis can reactivate when immunity is lowered. Screening is not bureaucracy — it is what makes long-term biologic treatment safe.
Used for Rheumatoid arthritis · Psoriatic arthritis
Common worries
Why did I need a TB test before starting?
Orencia calms T-cells, part of the immune system that keeps dormant TB contained. The test finds hidden TB so it can be treated first — that is what makes starting a biologic safe.
Infusion or home injection — does it matter?
Same medicine. Monthly infusions mean the team handles everything and checks on you; weekly home injections mean no travel. Most patients choose by routine, and either can be revisited.
What if I get a bad cold or flu?
Call us. Minor illnesses often just mean delaying a dose until you recover — but infections on a biologic deserve a conversation, not guesswork, and never double a dose to catch up.
Ready to be seen? New patients are seen within 2–4 weeks.