Abatacept therapy and safety management.

Abstract

OBJECTIVES:

To develop and/or update fact sheets about abatacept treatment, in order to assist physicians in the management of patients with inflammatory joint disease.

METHODS:

1. selection by a committee of rheumatology experts of the main topics of interest for which fact sheets were desirable 2. identification and review of publications relevant to each topic 3. development and/or update of fact sheets based on three levels of evidence: evidence-based medicine, official recommendations, and expert opinion. The experts were rheumatologists and invited specialists in other fields (dermatologist, cardiologist, pediatric rheumatologist, endocrinologist, hematologist, immunologist, infectiologist), and they had extensive experience with the management of chronic inflammatory diseases, such as rheumatoid arthritis (RA). They were members of the CRI (Club Rhumatismes et Inflammation), a section of the French Rheumatology Society (Societe Francaise de Rhumatologie). Each fact sheet was revised by several experts and the overall process was coordinated by three experts.

RESULTS:

Several topics of major interest were selected: contraindications of abatacept treatment; management of adverse effects and concomitant diseases that may develop during abatacept treatment; and management of common situations such as pregnancy, surgery, patient older than 75 years of age, and patients with co-morbidities (such as dialysis, hemoglobinopathy, or splenectomy). After a review of the literature and discussion among experts, a consensus was developed about the content of the fact sheets presented here. These fact sheets focus on several points: 1. in RA, initiation and monitoring of the abatacept treatment, management of patients with specific past histories, and specific clinical situations such as pregnancy 2. diseases other than RA, such as juvenile idiopathic arthritis, spondylarthropathies, or autoimmune diseases (systemic lupus erythematosus and other systemic autoimmune diseases) 3. models of letters for informing the rheumatologist and general practitioner 4. patient information about the use of abatacept in RA 5. and data on the new abatacept formulation for subcutaneous administration (approved by the FDA in August 2011 for patients with moderate-to-severe RA).

CONCLUSION:

These fact sheets built on evidence-based medicine and expert opinion will serve as a practical tool for assisting physicians who manage patients on abatacept. They will be available continuously on www.cri-net.com and will be updated at appropriate intervals.

• Authors: Thao Pham, Hervé Bachelez, Jean-Marie Berthelot, Jacques Blacher, Pascal Claudepierre, Arnaud Constantin, Bruno Fautrel, Cécile Gaujoux-Viala, Vincent Goëb, Laure Gossec, Philippe Goupille, Séverine Guillaume-Czitrom, Eric Hachulla, Thierry Lequerré, Jean-Pierre Marolleau, Valérie Martinez, Charles Masson, Luc Mouthon, Xavier Puéchal, Pascal Richette, Alain Saraux, Thierry Schaeverbeke, Martin Soubrier, Manuelle Viguier, Olivier Vittecoq, Daniel Wendling, Xavier Mariette, Jean Sibilia
• Journal: Joint bone spine (Joint Bone Spine) Vol. 79 Suppl 1 Pg. 3-84 (Mar 2012) ISSN: 1778-7254 [Electronic] France
• PMID: 22541956 (Publication Type: Journal Article)
• Copyright: Copyright © 2012 Elsevier Masson SAS. All rights reserved.

Chemical References

• Antirheumatic Agents
• Immunoconjugates
• Tumor Necrosis Factor-alpha
• Abatacept

Topics

• Abatacept
• Antirheumatic Agents (adverse effects, therapeutic use)
• Comorbidity
• Disease Management
• Evidence-Based Medicine
• Humans
• Immunoconjugates (adverse effects, therapeutic use)
• Practice Guidelines as Topic
• Rheumatic Diseases (drug therapy)
• Tumor Necrosis Factor-alpha (antagonists & inhibitors)