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Taking Abatacept For Rheumatoid Arthritis. Have You Ever Known Of Any Physician That Has Prescribed An Increase In Dosage Of Abatacept?

Posted on Tue, 10 Jul 2012

Question: I am seeking an expert Rheumatologist on Abatacept (Orencia) For Rheumatoid Arthritis. I have been on this medication by IV for about 10 months. My dosage is 750mg every 4 weeks. My weight is 190. Even though my Physician is an excellent Rheumatologist, she has admittedly had limited experience with prescribing Abatacept. Which leads me to my question. Have you ever, or have you ever known of any Physician that has prescribed an INCREASE in the DOSAGE of Abatacept by IV. For example, I stated that I was receiving 750mg, and I feel that because it isn't doing quite as much as it should be doing, I would like the next highest increment which is 1000mg. I should also state that I am well aware that there are numerous other drug options. But rather than explore them at this time, I would first like to know that we gave this drug every chance before yet again, starting from square one.

Answered by Dr. Aparna Kohli (15 minutes later)

Hi,
Thanks for writing in.
I am an associate in the department of Rheumatology. As far as the dosage of Abatacept (Orencia) in rheumatoid arthritis is concerned, the dose is 750 mg every 4 weeks for an adult who weighs less than 100 kg. It is 1000 mg every 4 weeks only for adults with a body weight of more than 100 kg. Since your weight is 86 kg, I would suggest that we stick with the lower dose of the drug. In the event that we do give you a higher dose, we should be looking at definitely more side effects with or without more clinical effectiveness. This means that while an increase in the dose may not produce a significant improvement in your clinical condition, it will produce more side effects. Side effects of this drug include headache, upper respiratory tract infections etc. It would be a better option to explore other drugs.
I have personally sought the advise of a XXXXXXX professor in rheumatology in this regard. As soon as we have his answer, we would get back to you.
Appreciate your patience
Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Aparna Kohli (7 minutes later)

I would first like to hear the answer from the more qualified XXXXXXX Professor, and this time please answer the question that I asked. ("Have you ever, or have you ever known of any Physician that has prescribed an INCREASE in the DOSAGE of Abatacept by IV?") I do not have any side effects from this medication. I need an answer from a Physician who has prescribed Orencia in the past.

Answered by Dr. Aparna Kohli (13 hours later)

Hi,
Thanks for writing in.
I believe that a XXXXXXX rheumatologist is directly in touch with you. I personally do not know any physician who has prescribed an increased dosage of Abatacept. In fact, such a thing has not even been tried in clinical trials. I would be available to address any more concerns that you might have.
If you do not have any further concerns, please close this discussion.
Warm regards

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar