
Rheumatoid Arthritis. On Medication. Can I Increase The Dosage Of Abatacept By IV? Other Options?

For rheumatoid arthritis, 750 mg is the dose recommended for a person weighing between 6o and 100 kgs. (your weight).
I do not know any physician who has exceeded this dosage. The reason for this that dosage have been decided after extensive research. It is especially true for all biologicals (the category of medications under which abatacept falls) that beyond a certain dose they do not have any enhanced action.
It is also known that one biological may not be effective, but the other could have dramatic results in a the same patient. Hence, it is wiser to change the biological rather than escalate the dose. You may also predispose yourself to side effects if the dose is increased.
Hope your query is answered and write back if you have a follow up query.
Dr Praveen Jadhav




I promise this is my last question. What I can't understand is, if the dosage amount is all based on how much the patient weighs, then why does the person that weighs 199 get 750mg and the person that weighs only 2 pounds more (201) get 1000mg. Why, because the cut off is 200lbs for those that get the larger dosage. That being the case, how XXXXXXX can it be for me to only receive 750mg (I weigh 190) versus receiving 1000mg? The guy that weighs 10 pounds more gets 1000mg. Should I eat more to gain 10 more pounds? Technically because of my weight and the calculations on the Orencia web-site, I should be receiving 860mg, but it only comes in 3 sizes. 500, 750, & 1000mg. Taking into consideration all that information, in your opinion, wouldn't trying 1000mg at least be worth a try? Having had RA for 16 years, I am here to tell you that starting from square one with a new biologic YET AGAIN, isn't as easy as it sounds. (and being on prednisone for over a year!) Thank-you for your time and patience. PS I cannot tolerate Methotrexate or Arava
Your argument seems quite reasonable. Though I would be tempted to use a higher dose of abatacept for you based on your argument, I doubt whether your doctor would do it. Again, this is from fear of legal implications which may ensue on crossing upper prescribed dose (just in case, if any complications).
The company decides the dosages based on extensive research on animals and volunteers. They (dosages) are based on data available from the studies. The FDA does not permit a medication to be used in dosages not yet studied (though logically it could correct). It is possible that the permitted dosages could increase in future after the drugs are studied further. However, in current scenario, it could be difficult.
Lastly, you should not be pessimistic in trying a new drug. It is possible that the newer medication may act faster and could be more effective. For example, infliximab (remicade) can act just in about 2 weeks and is very effective for RA.
Good luck with your health
Dr Jadhav

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