Signs & symptoms & inhibiting the progression of structural damage in adults w/ moderately to severely active RA as monotherapy or in combination w/ methotrexate (MTX) in patients w/ inadequate response to MTX alone. Polyarthritis (rheumatoid factor +ve or -ve) & extended oligoarthritis in childn & adolescents from 2 yr who have had inadequate response to, or who have proved intolerant of MTX. Psoriatic arthritis in adolescents from 12 yr who have had an inadequate response to, or who have proved intolerant of MTX. Enthesitis-related arthritis in adolescents from 12 yr who have had an inadequate response to, or who have proved intolerant of conventional therapy. Reduction of signs & symptoms of active arthritis in adults w/ psoriatic arthritis as monotherapy or in combination w/ MTX in patients w/ inadequate response to MTX alone. Signs & symptoms of active ankylosing spondylitis in adults w/ inadequate response to conventional therapy. Severe non-radiographic axial spondyloarthritis who have had an inadequate response to NSAIDs in adults. Adults w/ moderate to severe chronic plaque psoriasis who are unresponsive, w/ contraindications to, or intolerant to other systemic therapy including cyclosporine, MTX or PUVA. Chronic severe plaque psoriasis in childn & adolescent from 6 yr who are inadequately controlled by, or intolerant to other systemic therapies or phototherapies.
Adult 18-64 yr & elderly (≥65 yr)RA, psoriatic arthritis, ankylosing spondylitis & non-radiographic axial spondyloarthritis 25 mg twice wkly or 50 mg once wkly. Plaque psoriasis 25 mg twice wkly or 50 mg once wkly. Alternatively, 50 mg twice wkly for up to 12 wk followed by 25 mg twice wkly or 50 mg once wkly, if necessary. May be used for up to 24 wk. Discontinue treatment if no response after 12 wk. Juvenile idiopathic arthritis 0.4 mg/kg (up to a max of 25 mg/dose) twice wkly as a SC inj w/ 3-4 days interval between doses or 0.8 mg/kg (up to a max of 50 mg/dose) given once wkly. Discontinue treatment if no response after 4 mth. Paed plaque psoriasis (≥6 yr) 0.8 mg/kg (up to a max of 50 mg/dose) once wkly for up to 24 wk. Discontinue treatment if no response after 12 wk.
History of recurring or chronic infections or w/ underlying conditions which may predispose patients to infections. Discontinue use if a serious infection develops. Evaluate infections before, during & after treatment. Evaluate active or latent infection in patients at increased risk for TB before initiation of therapy. Monitor for signs & symptoms of active TB including patients tested -ve for latent TB infection. Previous HBV infection. Monitor patients for signs & symptoms of active HBV infection throughout & post therapy. Worsening of hepatitis C. Concomitant use w/ anakinra & abatacept. Not recommended for the treatment of Wegener's granulomatosis. Discontinue immediately if serious allergic or anaphylactic reaction occurs. Patients w/ immunosuppression or chronic infections. Possible risk for development of lymphomas or other haematopoietic or solid malignancies. Malignancies (particularly Hodgkin's & non-Hodgkin's), some fatal, among childn & adolescents. Perform periodic skin exam in patients at increased risk for skin cancer. History of blood dyscrasias. May result in the formation of autoimmune antibodies. Live vaccines should not be given concurrently. Careful risk/benefit evaluation including a neurologic assessment in patients w/ preexisting or recent onset of demyelinating disease. CHF; hypoglycemia (diabetes patients); inflammatory bowel disease in patients w/ JIA. Moderate to severe alcoholic hepatitis. Combination w/ other systemic therapies or phototherapy for psoriasis treatment. May result in the formation of autoimmune antibodies. Women of childbearing potential should be advised not to get pregnant during therapy. Not recommended during pregnancy. Lactation. Childn <2 yr (juvenile idiopathic arthritis); <6 yr (plaque psoriasis).
Increased incidences of serious adverse events w/ abatacept. Higher rate of serious infections & neutropenia w/ anakinra. Decrease in mean WBC counts w/ sulfasalazine. Concurrent use w/ live vaccines.
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