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Abatacept
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| Systematic (IUPAC) name | |
| Unable to be assigned | |
| Identifiers | |
| CAS number | ? |
| ATC code | L04 |
| PubChem | ? |
| DrugBank | |
| Chemical data | |
| Formula | ? |
| Mol. mass | ? |
| Pharmacokinetic data | |
| Bioavailability | ? |
| Metabolism | ? |
| Half life | ? |
| Excretion | ? |
| Therapeutic considerations | |
| Pregnancy cat. |
C (U.S.) |
| Legal status |
POM (UK), ℞-only (U.S.) |
| Routes | Intravenous |
Abatacept (marketed as Orencia) is a fusion protein composed of an immunoglobulin fused to the extracellular domain of CTLA-4, a molecule capable of binding B7. Abatacept is a selective costimulation modulator as it inhibits the costimulation of T cells. It was developed by Bristol-Myers-Squibb and is licensed in the United States for the treatment of rheumatoid arthritis in the case of inadequate response to anti-TNFα therapy.
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Mechanism of action
Ordinarily, full T cell activation requires 1) binding of the T cell receptor to the antigen-MHC complex on the antigen presenting cell (APC) and 2) a costimulatory signal provided by the binding of the T cell's CD28 protein to the B7 protein on the APC. Abatacept, which contains a high-affinity binding site for B7, works by binding to the B7 protein on APCs and preventing them from delivering the costimulatory signal to T cells, thus preventing the full activation of T cells.[1][2]
Abatacept is the basis for the second-generation belatacept currently being tested in clinical trials. In organ transplantation, it is intended to provide extended graft survival while limiting the toxicity generated by standard immune-suppressing regimens such as calcineurin inhibitors (eg, ciclosporin).
Indications
Abatacept is currently approved for use in rheumatoid arthritis patients who have had an inadequate response to one or more DMARDs.[3] It is useful in delaying the progression of structural damage and reducing symptoms of rheumatoid arthritis. However, it should not be used in combination with anakinra or TNF antagonists.[4] It is also likely to be beneficial in the treatment of psoriasis and in organ transplantation.citation needed
Abatacept is currently in trial[5] for the treatment of patients suffering moderate to severe active ulcerative colitis, where response to standard treatment has failed to bring about remission.
Abatacept is also currently in trial[6] for the treatment of Type 1 Diabetes. In diabetic patients in the "honeymoon phase" of the disease, Abatacept may protect surviving beta cells from autoimmune attack.
Structure
Abatacept is a fusion protein composed of the extracellular domain of CTLA-4 with the hinge, CH2, and CH3 domains of IgG1.[4]
Similar agents
References
- ^ "ABATACEPT & BELATACEPT: the CTLA-4-Igs". Healthvalue.net. Retrieved on 2007-05-25.
- ^ Dall'Era M, Davis J (2004). "CTLA4Ig: a novel inhibitor of co-stimulation". Lupus 13 (5): 372–376. doi:. PMID 15230295.
- ^ Bristol-Myers Squibb (March 13, 2007). ORENCIA labelPDF (110 KiB). United States Food and Drug Administration. Retrieved on 2007-05-25.
- ^ a b Moreland L, Bate G, Kirkpatrick P (2006). "Abatacept". Nature Reviews Drug Discovery 5: 185–186. doi:. PMID 16557658.
- ^ "A Study of Abatacept in Patients With Active Ulcerative Colitis". ClinicalTrials.gov. United States National Institutes of Health (May 11, 2007). Retrieved on 2007-05-25. ClinicalTrials.gov Identifier NCT00410410.
- ^ "CTLA-4 Ig (Abatacept) in Recent Onset Diabetes". diabetestrialnet.org. TrialNet. Retrieved on 2008-08-08. diabetestrialnet.org.
External links
Wikipedia content modification information:
- This page was last modified on 29 September 2008, at 00:30.
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