2/1/12 Taking a break from the biologic medication abatacept, or Orencia, will not affect your long-term response to therapy, according to a study published in the January 2012 issue of the Annals of the Rheumatic Diseases.
That’s good news for patients who either want or need a “drug holiday,” says the study’s lead author, Jeffrey Kaine, MD, director of Sarasota Arthritis Research Center in Sarasota, Fla.
“We don’t encourage people to stop medications,” says Dr. Kaine. “But the reality is they may go on vacation, or get an upper respiratory infection, need to have surgery, or have a change in insurance and delay in getting medications.” They might also stop for a while to see if their disease is in remission, although that should be done only with a doctor’s supervision. Since people do sometimes go off their medication, Dr. Kaine adds, “It’s nice to know if there’s a potential problem [from stopping and restarting].”
Abatacept belongs to a class of drugs called biologics. The majority of biologics work by inhibiting tumor necrosis factor-alpha, or anti-TNFs. Abatacept works by blocking the activity of T-cells, a type of immune cell that is thought to be responsible for the pain and swelling in joints of people with rheumatoid arthritis, or RA.
Previous reports have indicated that a drug holiday from a biologic may be cause for concern; a few patients taking a break from infliximab, or Remicade, – an anti-TNF biologic – developed antibodies to the actual medication. When they restarted the medication, they were less able to tolerate it, due to increased toxicity, Dr. Kaine explains. In some patients, this antibody formation has been associated with reduced responsiveness to infliximab and another anti-TNF, adalimumab, or Humira.
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