Advice on Speaking with your Rheumatoid Arthritis Doctor

Talking to your rheumatologist

Work with your doctor to get the best care

Your rheumatologist is your partner in managing your moderate to severe rheumatoid arthritis and is responsible for treating your disease. He or she needs to know how you're feeling—and how your symptoms are affecting you—in order to help you reach your goals. A good relationship with your doctor takes planning and preparation. We've developed some tools to help you get started:

Assess how your RA affects you. Use the Satisfaction RAter to help you understand how your symptoms impact your daily life.

Are you asking the right questions? How well prepared are you to have a conversation with your rheumatologist about RA? Get answers with the Doctor Discussion Guide below.

Be prepared for your next doctor visit.
So you can get more out of it.

You play a very important role
at your doctor's appointments:

Doctors cannot get the complete story from
lab tests alone. They need your input.

Let them know about any changes you've
experienced over time—big and small.

The more information you give them, the better
decisions they'll be able to make for your RA.

What your doctor will probably bring up: the numbers

Keep in mind that there are things that don't show up
on test results. But they are important for your doctor
to know because they are signs of disease activity,
as well as indications of how you're doing overall.

These are:

Some physical symptoms of your RA

As well as the emotional and social impact of the
disease

These factors, together with your results, will give you
and your doctor a complete picture.

Download the RA Symptom Tracker to record your symptoms, treatment goals, and progress, so you'll have some concrete details to discuss with your doctor during future visits.

Keep your rheumatologist informed of how you are feeling, even if you feel like you've spoken about it before. Always let your rheumatologist know if there are any changes, either good or bad, in your physical and emotional well-being, so he or she can give you the best care possible.

Include loved ones in the decision-making process
Taking care of yourself for your friends and family is important, but it's also important to let them lend you support. Your rheumatoid arthritis treatment team shouldn't only include rheumatologists and other doctors, but also members of your family and those closest to you.

Learning to ask for help and relying on others for support can be an important part of rheumatoid arthritis treatment. Just having someone to listen to you and to discuss your condition with can be a great comfort to you. Opening up to your support team is an excellent way to share your feelings and it gives them a chance to help you when you need it most.

Other helpful resources
Part of exploring rheumatoid arthritis treatment options is knowing as much as you can about your disease. So here are a few Web sites you can turn to for more information, if you haven't already.

Arthritis Support
Arthritis Support is a site where you can chat with others who have
rheumatoid arthritis, post messages or take part in online forums.

Arthritis Foundation
The Arthritis Foundation is a national not-for-profit organization
with advocacy, programs, services and research in arthritic conditions including rheumatoid arthritis.

Arthritis Insight
Arthritis Insight is where you can read information on
rheumatoid arthritis. You can also find support from
others living with rheumatoid arthritis.

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ORENCIA® (abatacept) Important Safety Information

Indication and Usage
ORENCIA® (abatacept) is a prescription medicine that reduces signs and symptoms in adults with moderate to severe rheumatoid arthritis (RA), including those who have not been helped enough by other medicines for RA. ORENCIA may prevent further damage to your bones and joints, and may help your ability to perform daily activities. ORENCIA also reduces signs and symptoms in children and adolescents 6 years of age and older with moderate to severe polyarticular juvenile idiopathic arthritis (JIA).

ORENCIA can also make your immune system less able to fight infections, so you may be more likely to get infections or any infection you have may get worse. It is important to tell your doctor if you think you have any infections.

Important Safety Information About ORENCIA^® (abatacept)

Before you receive treatment with ORENCIA, a lyophilized powder for intravenous infusion, you should tell your doctor about all your medical conditions, including if you:

	have any kind of infection even if it is small (such as an open cut or sore) or an infection that is in your whole body (such as the flu).
	have an infection that will not go away or a history of infections that keep coming back.
	have had tuberculosis (TB), a positive skin test for TB, or if you recently have been in close contact with someone who has had TB. If you get any of the symptoms of TB (a dry cough that doesn't go away, weight loss, fever, night sweats), call your doctor right away. Before you start ORENCIA, your doctor may examine you for TB or perform a skin test.
	have or have had viral hepatitis. Before you use ORENCIA, your doctor may examine you for hepatitis.
	have a history of chronic obstructive pulmonary (lung) disease (COPD).
	are scheduled to have surgery.
	are allergic to any of the following ingredients in ORENCIA: abatacept, maltose, monobasic sodium phosphate, or sodium chloride for administration.
	recently received a vaccination or are scheduled for any vaccination. You should not take live vaccines if you are receiving ORENCIA.
	have diabetes and use a blood glucose monitor to check your sugar levels. The infusion of ORENCIA contains maltose, a sugar that can give falsely high blood glucose readings with some monitors on the day you receive your infusion. Your doctor may tell you to use a different way to monitor your blood sugar levels.
	are pregnant, planning to become pregnant, or are thinking about becoming pregnant. It is not known if ORENCIA can harm your unborn baby.
	are breast-feeding. You will need to decide to either breast-feed or receive treatment with ORENCIA, but not both.
	take any other kinds of medicine, including prescription and nonprescription medicines, vitamins, and herbal supplements.
	are taking other biologic medicines to treat RA or JIA such as: Enbrel^® (etanercept), Humira^® (adalimumab), Remicade^® (infliximab), Kineret^® (anakinra) or Rituxan^® (rituximab). You may have a higher chance of getting a serious infection if you take ORENCIA with other biologic medicines.

Possible Side Effects of ORENCIA® (abatacept)

ORENCIA can cause serious side effects including:

	Serious infections. Patients receiving ORENCIA have a higher chance of getting infections including pneumonia, and other infections caused by viruses, bacteria, or fungi. Call your doctor immediately if you feel sick or get any of the following signs of infection: fever, feel very tired, cough, feel flu-like, or warm, red or painful skin.
	Allergic reactions. Allergic reactions can happen on the day of treatment or the day after receiving ORENCIA. Tell your doctor or get emergency medical help right away if you have hives, swollen face, eyelids, lips, tongue, throat or trouble breathing.
	Cancer (malignancies). Certain kinds of cancer have been reported in patients receiving ORENCIA. It is not known if ORENCIA increases your chance of getting certain kinds of cancer.
	Vaccinations. You should not receive ORENCIA with certain types of vaccines. ORENCIA may cause some vaccinations to be less effective.
	Respiratory problems in patients with COPD. You may get certain respiratory problems more often if you receive ORENCIA and have COPD, including: worsened COPD, pneumonia, cough, or trouble breathing.

The more common side effects with ORENCIA in both adults and children are headache, upper respiratory tract infection, sore throat, and nausea. Other side effects in children may include diarrhea, cough, fever, and abdominal pain.

Please read the Patient Information in the Full Prescribing Information.

© 2009 Bristol-Myers Squibb. All Rights Reserved.
ORENCIA is a registered trademark, and Oh, yes I can!, The Circle, The ORENCIA Promise Program, and the Satisfaction RAter are trademarks of Bristol-Myers Squibb.

427US07WA38036 Nov/09