Monograph
L04AA24 - Abatacept |
Propably not porphyrinogenic |
PNP |
Important Information
Patients on immunosuppressive therapy have an increased risk of infections. Since infections have a potential to trigger acute porphyric attacks vigilance is motivated regarding signs or symptoms of infection and/or possible symptoms of a porphyric attack. Side effects like nausea and vomiting may potentially be porphyrinogenic through reduction in carbohydrate intake.
Side effects
Infections are common in patients using immunosuppressants and since infections might trigger an acute porphyric attack, vigilance regarding signs and symptoms of an infection and/ or a porphyric attack is recommended. Common adverse reactions of abatacept that can be confused with an acute porphyric attack are nausea and vomiting. These side effects may potentially be porphyrinogenic if leading to a decrease in carbohydrate intake.
Rationale
Abatacept is not metabolized by cytochrome P450 enzymes. No pharmacokinetic porphyrinogenic effects are suspected.
Chemical description
Abatacept, a recombinant fusion protein, consists of the extracellular domain of human cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) linked to a modified Fc portion of human immunoglobulin G1 (IgG1).
Therapeutic characteristics
Abatacept is used in the treatment of moderate to severe active rheumatoid arthritis, and is given by intravenous infusion.
Metabolism and pharmacokinetics
Protein, not metabolized by CYP enzymes. No formal drug-drug-interaction studies have been conducted, but are nor expected considering the nature of the product.
References
| # | Citation details | PMID |
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| * | Drug reference publications | |
| 1. | McEvoy GK, editor. Abatacept. The AHFS Drug Information 2008. Bethesda, MD: American Society of Health-System Pharmacists; 2009. Electronic version (31.08.10).
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| 2. | Sweetman SC, editor. Martindale: The complete drug reference. Abatacept. Pharmaceutical Press 2009.
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| * | Government bodies | |
| 3. | European Public Assessment Report, Orencia (Scientific discussion).European Medicines Agency (EMEA). Accessible from: emea.europa.eu
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| * | Summary of Product Characteristics | |
| 4. | The electronic Medicines Compendium (emc). Summary of Product Characteristics (SPC). Orencia.
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