Rheumatoid Arthritis Medication | ORENCIA® (abatacept)

Getting started with ORENCIA

Your first steps

If you and your rheumatologist decide that ORENCIA^® (abatacept) IV is right for you, here are a few things you can expect to happen:

PRESCRIPTION
Your rheumatologist will prescribe your dose (how much ORENCIA you'll need) and tell you when to schedule your first appointment to receive treatment of ORENCIA.

DOSING
ORENCIA is a 30-minute intravenous (IV) infusion given by a healthcare professional. You will receive your first dose of ORENCIA followed by a second dose around day 15 and a third dose around day 30. You will then continue therapy of one dose every 4 weeks thereafter. Please note that the actual day of dosing may vary based on patient scheduling.

INFUSION
After arriving for treatment, someone may check your vital signs (temperature, heart rate, blood pressure, etc.) and you may have a routine physical exam. You will be seated in an infusion chair, which is similar to a recliner or lounge chair. The infusion lasts about half an hour, however your total "seat time" may be longer. During treatment, many people like to read a book, listen to music on a headset, or watch television. While individual experiences may vary, patients can usually maintain their normal schedule while receiving ORENCIA.

SAFETY INFORMATION ABOUT ALLERGIC REACTIONS
Allergic reactions can happen on the day of treatment or the day after receiving ORENCIA. Tell your healthcare provider or get emergency medical help right away if you have hives, swollen face, eyelids, lips, tongue, throat or trouble breathing.

SCHEDULE
Keep track of your scheduled office visits and appointments. It is very important to receive treatment of ORENCIA exactly as prescribed by your rheumatologist. If you miss an infusion appointment for ORENCIA, contact your rheumatologist immediately to find out when you should get your next dose.

COMMUNICATION
Keep communicating with your rheumatologist and other healthcare professionals about how you are feeling both before and after your infusions of ORENCIA. Work with your rheumatologist and other healthcare professionals to set your personal treatment goals, which may include reducing pain, maintaining physical function for activities of daily living and work, improving health-related quality of life, and slowing the progression of joint damage. Staying involved by talking to your rheumatologist is one way to help reach these goals.

SUPPORT
Because rheumatoid arthritis can affect each patient differently, we have created a flexible support program called The Circle™. The Circle™ is a unique program designed to suit your particular needs, while giving you ongoing support, such as tips and tools. To learn more about how we can help you every step of the way, click here.

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. In adults, ORENCIA may be used alone or with other RA treatments other than tumor necrosis factor (TNF) antagonists.

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 may be used alone or with methotrexate (MTX).

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 healthcare provider 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 or a solution for subcutaneous (under the skin) injection you should tell your healthcare provider 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 does not go away, weight loss, fever, night sweats), call your healthcare provider right away. Before you start ORENCIA, your healthcare provider may examine you for TB or perform a skin test.
	have or have had viral hepatitis. Before you use ORENCIA, your healthcare provider 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 for infusion: abatacept, maltose, monobasic sodium phosphate, and sodium chloride for administration or the ingredients in ORENCIA injection: abatacept, sucrose, poloxamer 188, monobasic sodium phosphate monohydrate, dibasic sodium phosphate anhydrous, and water for injection.
	recently received a vaccination or are scheduled for any vaccination. If you are receiving ORENCIA, and for 3 months after you stop receiving ORENCIA, you should not take live vaccines.
	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 healthcare provider may tell you to use a different way to monitor your blood sugar levels. ORENCIA for subcutaneous injection (injected under the skin) does not contain maltose; therefore, you do not need to change the way you monitor your blood sugar if you are taking ORENCIA subcutaneously.
	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), Rituxan® (rituximab), Simponi® (golimumab), Cimzia® (certolizumab pegol), Actemra® (tocilizumab). 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. Serious infections, including rare but fatal infections, can occur. ORENCIA can make you more likely to get infections or make the infection that you have get worse. Call your healthcare provider 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 healthcare provider or get emergency medical help right away if you have hives, swollen face, eyelids, lips, tongue, throat or trouble breathing.
	Hepatitis B infection. If you are a carrier of the hepatitis B virus (a virus that affects the liver), the virus can become active while you use ORENCIA. Your healthcare provider may do a blood test before you start or while using ORENCIA.
	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.
	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.

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 and adolescents may include diarrhea, cough, fever, and abdominal pain.

Please read the Patient Information in the Full US Prescribing Information.

ORENCIA is a registered trademark, and "Oh, Yes I Can!", THE CIRCLE, THE ORENCIA^® (abatacept) COPAY PROGRAM, and the Satisfaction RAter are trademarks of
Bristol-Myers Squibb. All other trademarks are the property of their respective owners.

427US11WA19301 Sep/11