title: Practice guidelines for the use of subcutaneous abatacept.
abstract: OBJECTIVE
  To review the clinical evidence on subcutaneous (sc) abatacept and to formulate recommendations in order to clear up points related to its use in rheumatology.
  
  
  METHODS
  An expert panel of rheumatologists objectively summarized the evidence on the mechanism of action, practicality, effectiveness, and safety of abatacept sc and formulated recommendations after a literature review.
  
  
  RESULTS
  The efficacy and safety of abatacept sc was studied in 7 clinical trials, 3 double-blind, 3 open, and one mixed, with the following endpoints: comparison against abatacept iv, impact on immunogenicity, effect of replacing iv by sc, abatacept sc in monotherapy, and non-inferiority to adalimumab. No significant differences were found between sc and iv abatacept on efficacy or safety. The development of sc abatacept has allowed a complementary study to the iv, formulation, thus making the abatacept profile better defined.
  
  
  CONCLUSIONS
  This is a practical document to supplement the summary of product characteristics. In summary, abatacept sc is presented as an effective and safe drug and, therefore, as an alternative for use within the broad armamentarium the rheumatologist has to treat RA. It also has the advantage of being the only biological agent that can be administered iv and sc which can facilitate its use in certain patients.
authors.affiliation: Servicio de Reumatología, Hospital Universitario La Paz, IdiPAZ, Madrid, España. Electronic address: emartinmola.hulp@salud.madrid.org.
authors.forename: Emilio Martín
authors.initials: EM
authors.lastname: Mola
authors.affiliation: Servicio de Reumatología, Hospital Universitario La Paz, IdiPAZ, Madrid, España.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Balsa
authors.affiliation: Servicio de Reumatología, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, España.
authors.forename: Víctor
authors.initials: V
authors.lastname: Martínez Taboada
authors.affiliation: Servicio de Reumatología, Hospital Universitario Virgen de Valme, Sevilla, España.
authors.forename: José Luis
authors.initials: JL
authors.lastname: Marenco
authors.affiliation: Servicio de Reumatología, Hospital Universitario Virgen Macarena, Sevilla, España.
authors.forename: Federico
authors.initials: F
authors.lastname: Navarro Sarabia
authors.affiliation: Servicio de Reumatología, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, A Coruña, España; Departamento de Medicina, Universidad de Santiago de Compostela, Santiago de Compostela, A Coruña, España.
authors.forename: Juan
authors.initials: J
authors.lastname: Gómez-Reino
authors.affiliation: Servicio de Reumatología, Hospital Universitario de la Princesa, IIS Princesa, Madrid, España.
authors.forename: José María
authors.initials: JM
authors.lastname: Alvaro-Gracia
authors.affiliation: Servicio de Reumatología, Hospital Universitario y Politécnico La Fe, Valencia, España.
authors.forename: José Andrés
authors.initials: JA
authors.lastname: Román Ivorra
authors.affiliation: Servicio de Reumatología, Hospital Universitario La Paz, IdiPAZ, Madrid, España.
authors.forename: Leticia
authors.initials: L
authors.lastname: Lojo
authors.affiliation: Servicio de Reumatología, Hospital Universitario La Paz, IdiPAZ, Madrid, España.
authors.forename: Chamaida
authors.initials: C
authors.lastname: Plasencia
authors.affiliation: Servicio de Reumatología, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, A Coruña, España; Instituto de Salud Musculoesquelética, Madrid, España.
authors.forename: Loreto
authors.initials: L
authors.lastname: Carmona
mesh_terms: D000069594:Abatacept / Q000008:administration & dosage*; D018501:Antirheumatic Agents / Q000008:administration & dosage* / Q000493:pharmacokinetics; D006801:Humans; D007279:Injections, Subcutaneous; D017410:Practice Guidelines as Topic; D012216:Rheumatic Diseases / Q000188:drug therapy*
chemical_list: D018501:Antirheumatic Agents; D000069594:Abatacept
keywords: Abatacept; Cytotoxic T-Lymphocyte Antigen 4; Evidence-based practice; Práctica basada en pruebas