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about the paper just I need 3 to 4 slides include :Brand name, generic name, indication, dosage, route of administration intravenous or intramuscular 3 to 4 slides. I will post question just for making 3 to 4 slides. because it’s a group work and just I have to make 3 to 4 first slides about the grade.
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Abatacept
Soheila Karimi
Indication
Abatacept is considered to be the prescription made for the treatment of moderate to severe
rheumatoid arthritis (RA). It is specifically for adult patients who have not responded adequately
to other disease-modifying antirheumatic drugs (DMARDs), including methotrexate1. It is usually
employed to reduce the signs and symptoms of RA and indicate the progression of joint damage.
Pharmacokinetics Properties
Absorption
Abatacept is administered using subcutaneous injection, giving several advantages for
managing humanoid arthritis. The method of administration results in a sustained absorption of
the drug into the bloodstream directly2,3. The subcutaneous path also facilitates the gradual release
of Abatacept. This is considered to be important in the context of maintaining chronic autoimmune
diseases like RA.
The subcutaneous injection method is important for drugs that require constant therapeutic
levels across the body. This is because it is sustained in the release that contributes to the efficiency
of the drug in controlling the signs and symptoms of RA. It also allows the convenience of a dosing
regimen for patients3. This requires weekly administration of drugs to their patients. Physiological
barriers such as the skin and subcutaneous tissue do not necessarily affect the absorption process
for abatacept. Subcutaneous injection is usually designed to bypass the barriers without such
limitations. The path ensures that the drug is delivered directly into the subcutaneous tissue, which
can easily enter the circulation system. Figure one below shows the chemical structure of
Abatacept.
Figure 1: Chemical structure of Abatacept
Even though specific bioavailability of data for Abatacept and not always available across
the Internet, subcutaneous injection results in high bioavailability. This implies that a significant
portion of the administered dose reaches the bloodstream, leading to effective therapeutic
outcomes4. The high bioavailability is considered a favorable component because it allows for
lower drug doses, reduces the frequency of administration, and maintains therapeutic efficiency.
The absorption of Abatacept through this cutaneous injection offers a reliable and effective
approach to delivering the drug to the targeted tissue of rheumatoid arthritis. This law down the
release of drugs, which ensures a subcutaneous therapeutic level and makes it a valuable treatment
option for patients with moderate to severe or who have not responded properly to other therapies.
Distribution
The drug’s major target tissue is the synovial membrane across the joint affected by
rheumatoid arthritis. Considering the absorption into the bloodstream, Abatacept is suitably
distributed across the body with a key focus on joints affected by RA5. Unlike other medications,
Abatacept does not bind to plasma proteins, which allows it to be readily available for its intended
therapeutic processes.
Metabolism
Abatacept usually goes through minimal metabolism in the body, unlike many other drugs
that are extensively metabolized. Abatacept therapeutic effects are usually accomplished without
having significant metabolic transformation6,7. However, no known metabolites of their
medication have functional implications, and the elimination of the drug is not reliant on metabolic
processes.
Excretion
Abatacept is primarily excreted with the exact percentages and information about the renal
elimination process not readily available across the Internet. However, renal excretion is a common
root for removing drugs from the body.
Pharmacodynamics
Abatacept is usually classified as a disease modification antirheumatic drug (DMARD), a
T-cell co-simulation modulator. The medication is considered important in controlling T-cell
activation and reducing the inflammatory response, which is observed in patients having RA8. The
drug also interferes with the CD80/CD86-CD28 co-stimulatory signal, which specifically
decreases the T cell activation, which is considered the hallmark of the autoimmune response in
RA. Abatacept outlines a high affinity for CD80 and CD86 receptors, which is known to block the
interaction with CD28. The impact is that it mitigates the autoimmune response and reduces joint
inflammation and drag damage in RA patients.
Side Effects
The main side effect associated with the drug includes upper respiratory tract infections,
headache, and nausea. However, more serious side effects might occur, such as infections,
malignancies, and injection site reactions. Because of the immune response modulation, infections
can easily arise due to the suppressed immune system8,9. In addition, the long-term use of the drug
has been considered to increase the risk of malignancies even though these risks should be
balanced against the benefits of Disease Control. Therefore, it is suitable for individuals to
understand that Abatacept has a relatively narrow therapeutic index that emphasizes the need for
careful and constant monitoring during its use.
Other
In addition to its use in rheumatoid arthritis, the drug is also used to effectively treat other
autoimmune diseases, such as juvenile idiopathic arthritis (JIA). The drug is administered as a
subcutaneous injection once a week9. It effectively improves the signs and symptoms of RA and
slows down joint damage progression in clinical processes. Even though generally well-tailored,
the drug requires close monitoring because of the risk of infections and malignancies associated
with immune modulation. It sounds like an important treatment option for patients with moderate
to severe RA who have not responded positively to other therapies.
References
1. Blair, H. A., & Deeks, E. D. (2017). Abatacept: a review in rheumatoid arthritis. Drugs, 77,
1221-1233.
2. Furie, R., Nicholls, K., Cheng, T. T., Houssiau, F., Burgos‐Vargas, R., Chen, S. L., … &
Merrill, J. T. (2014). Efficacy and safety of abatacept in lupus nephritis: a twelve‐month,
randomized, double‐blind study. Arthritis & rheumatology, 66(2), 379-389.
3. Genovese, M. C., Becker, J. C., Schiff, M., Luggen, M., Sherrer, Y., Kremer, J., … &
Dougados, M. (2005). Abatacept for rheumatoid arthritis refractory to tumor necrosis
factor α inhibition. New England Journal of Medicine, 353(11), 1114-1123.
4. Genovese, M. C., Covarrubias, A., Leon, G., Mysler, E., Keiserman, M., Valente, R., … &
Alten, R. (2011). Subcutaneous abatacept versus intravenous abatacept: a phase IIIb
noninferiority study in patients with an inadequate response to methotrexate. Arthritis &
Rheumatism, 63(10), 2854-2864.
5. Kremer, J. M., Genant, H. K., Moreland, L. W., Russell, A. S., Emery, P., Abud-Mendoza,
C., … & Westhovens, R. (2006). Effects of abatacept in patients with methotrexate-resistant
active rheumatoid arthritis: a randomized trial. Annals of internal medicine, 144(12), 865876.
6. Maxwell, L., & Singh, J. A. (2009). Abatacept for rheumatoid arthritis. Cochrane
Database of Systematic Reviews, (4).
7. Moreland, L., Bate, G., & Kirkpatrick, P. (2006). Abatacept. Nature Reviews Drug
Discovery, 5(3).
8. Salem, J. E., Allenbach, Y., Vozy, A., Brechot, N., Johnson, D. B., Moslehi, J. J., &
Kerneis, M. (2019). Abatacept for severe immune checkpoint inhibitor–associated
myocarditis. New England Journal of Medicine, 380(24), 2377-2379.
9. Yu, C. C., Fornoni, A., Weins, A., Hakroush, S., Maiguel, D., Sageshima, J., … & Mundel,
P. (2013). Abatacept in B7-1–positive proteinuric kidney disease. New England Journal of
Medicine, 369(25), 2416-2423.
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