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Pharmacy and Medications

Does Orencia Work Differently than Enbrel?

02/19/2009

Question:

I have Rheumatoid Arthritis and have been on Enbrel for a year and had a cold once in that year but it did help my Rheumatoid Arthritis. Enbrel stoped working after a year and was switched to Humira. That I had a sevre allergic reaction to. Now I am on Orencia for six months and my Rheumatoid Arthritis has gotten worse and I have had a cold three times. One of those times it lasted for 6 weeks. Could the Orencia be causing me to be more sick then normal? Does Orencia work differently than Enbrel and is that why I am sick more often?

Answer:

Thank you for visiting NetWellness. Abatacept (Orencia®) is in a class of immune modulators that treat persons who have moderate to severe rheumatoid arthritis (RA) who have had inadequate response to other therapies such as etanercept (Enbrel®).

Orencia® does work differently than Enbrel®. Compared with the general population, patients with RA have a heightened risk of infection. The most common areas of infection are the respiratory tract (including pneumonia), skin and soft tissue, and the urinary tract.

The immune system defends the body against infections caused by bacteria and viruses. A normal immune system leaves healthy body tissues alone. In people with RA, the immune system attacks normal body tissues causing damage and inflammation especially in the tissues of your joints. Orencia® helps your body not to attack the normal body tissue, but a side effect is that it can lower your immune system to fight infections.

Side effects of Orencia® are infections such as upper respiratory infection, bronchitis, pneumonia and urinary tract infections. A study (Furst DE "The Risk of Infections with Biologic Therapies for Rheumatoid Arthritis" Semin Arthritis Rheum 2008 Dec. 29) looked at the comparisons between the rates of illness of patients with RA in relation to use of biologic therapies such as Orencia® and Enbrel®. There is not evidence that one increases infections or duration over another.

You can still receive flu and pneumonia vaccinations and they are usually effective. You need to make sure you work with your physician to decide the best time in relation to your infusion to receive these vaccinations. It is always important to notify your physician when you develop any infection.

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Response by:

Sarah Hudson-DiSalle, PharmD, RPh
Specialty Practice Pharmacist of Outpatient Pharmacy
College of Medicine
The Ohio State University