title: Abatacept therapy and safety management.
abstract: OBJECTIVE
  To develop and/or update fact sheets about abatacept treatment, in order to assist physicians in the management of patients with inflammatory joint disease.
  
  
  METHODS
  1. selection by a committee of rheumatology experts of the main topics of interest for which fact sheets were desirable 2. identification and review of publications relevant to each topic 3. development and/or update of fact sheets based on three levels of evidence: evidence-based medicine, official recommendations, and expert opinion. The experts were rheumatologists and invited specialists in other fields (dermatologist, cardiologist, pediatric rheumatologist, endocrinologist, hematologist, immunologist, infectiologist), and they had extensive experience with the management of chronic inflammatory diseases, such as rheumatoid arthritis (RA). They were members of the CRI (Club Rhumatismes et Inflammation), a section of the French Rheumatology Society (Societe Francaise de Rhumatologie). Each fact sheet was revised by several experts and the overall process was coordinated by three experts.
  
  
  RESULTS
  Several topics of major interest were selected: contraindications of abatacept treatment; management of adverse effects and concomitant diseases that may develop during abatacept treatment; and management of common situations such as pregnancy, surgery, patient older than 75 years of age, and patients with co-morbidities (such as dialysis, hemoglobinopathy, or splenectomy). After a review of the literature and discussion among experts, a consensus was developed about the content of the fact sheets presented here. These fact sheets focus on several points: 1. in RA, initiation and monitoring of the abatacept treatment, management of patients with specific past histories, and specific clinical situations such as pregnancy 2. diseases other than RA, such as juvenile idiopathic arthritis, spondylarthropathies, or autoimmune diseases (systemic lupus erythematosus and other systemic autoimmune diseases) 3. models of letters for informing the rheumatologist and general practitioner 4. patient information about the use of abatacept in RA 5. and data on the new abatacept formulation for subcutaneous administration (approved by the FDA in August 2011 for patients with moderate-to-severe RA).
  
  
  CONCLUSIONS
  These fact sheets built on evidence-based medicine and expert opinion will serve as a practical tool for assisting physicians who manage patients on abatacept. They will be available continuously on www.cri-net.com and will be updated at appropriate intervals.
authors.affiliation: Service de Rhumatologie, CHU Sainte-Marguerite, Marseille. thao.pham@ap-hm.fr
authors.forename: Thao
authors.initials: T
authors.lastname: Pham
authors.forename: Hervé
authors.initials: H
authors.lastname: Bachelez
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Berthelot
authors.forename: Jacques
authors.initials: J
authors.lastname: Blacher
authors.forename: Pascal
authors.initials: P
authors.lastname: Claudepierre
authors.forename: Arnaud
authors.initials: A
authors.lastname: Constantin
authors.forename: Bruno
authors.initials: B
authors.lastname: Fautrel
authors.forename: Cécile
authors.initials: C
authors.lastname: Gaujoux-Viala
authors.forename: Vincent
authors.initials: V
authors.lastname: Goëb
authors.forename: Laure
authors.initials: L
authors.lastname: Gossec
authors.forename: Philippe
authors.initials: P
authors.lastname: Goupille
authors.forename: Séverine
authors.initials: S
authors.lastname: Guillaume-Czitrom
authors.forename: Eric
authors.initials: E
authors.lastname: Hachulla
authors.forename: Thierry
authors.initials: T
authors.lastname: Lequerré
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Marolleau
authors.forename: Valérie
authors.initials: V
authors.lastname: Martinez
authors.forename: Charles
authors.initials: C
authors.lastname: Masson
authors.forename: Luc
authors.initials: L
authors.lastname: Mouthon
authors.forename: Xavier
authors.initials: X
authors.lastname: Puéchal
authors.forename: Pascal
authors.initials: P
authors.lastname: Richette
authors.forename: Alain
authors.initials: A
authors.lastname: Saraux
authors.forename: Thierry
authors.initials: T
authors.lastname: Schaeverbeke
authors.forename: Martin
authors.initials: M
authors.lastname: Soubrier
authors.forename: Manuelle
authors.initials: M
authors.lastname: Viguier
authors.forename: Olivier
authors.initials: O
authors.lastname: Vittecoq
authors.forename: Daniel
authors.initials: D
authors.lastname: Wendling
authors.forename: Xavier
authors.initials: X
authors.lastname: Mariette
authors.forename: Jean
authors.initials: J
authors.lastname: Sibilia
mesh_terms: D000069594:Abatacept; D018501:Antirheumatic Agents / Q000009:adverse effects / Q000627:therapeutic use; D015897:Comorbidity; D019468:Disease Management; D019317:Evidence-Based Medicine; D006801:Humans; D018796:Immunoconjugates / Q000009:adverse effects* / Q000627:therapeutic use*; D017410:Practice Guidelines as Topic; D012216:Rheumatic Diseases / Q000188:drug therapy*; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D018501:Antirheumatic Agents; D018796:Immunoconjugates; D014409:Tumor Necrosis Factor-alpha; D000069594:Abatacept