CTLA4-Immunoglobulin
Abatacept is a selective costimulation modulator that inhibits T-cell activation.
Abatacept (Orencia, Orencia ClickJect)
Chimeric protein which inhibits T-lymphocyte activation by binding to CD80 and CD86 located on antigen presenting cells (APC). T-cell activation is dependent on interacting with APC. Indicated for active psoriatic arthritis in adults.
Related Questions:
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Mease PJ, Gladman DD, Ritchlin CT, Ruderman EM, Steinfeld SD, Choy EH, et al. Adalimumab for the treatment of patients with moderately to severely active psoriatic arthritis: results of a double-blind, randomized, placebo-controlled trial. Arthritis Rheum. 2005 Oct. 52(10):3279-89. [Medline].
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Severe fixed flexion deformity of the interphalangeal joint.
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Comparison between sites of involvements in both hands and feet in psoriatic arthritis and rheumatoid arthritis.
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Psoriatic arthritis involving the distal phalangeal joint.
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Swelling and deformity of the metacarpophalangeal and distal interphalangeal joints in a patient with psoriatic arthritis.
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Psoriatic arthritis involving the distal phalangeal joint.
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Psoriatic arthritis involving the distal phalangeal joint.
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Asymmetrical arthritis pattern of psoriatic arthritis (fixed flexion deformity).
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Arthritis mutilans, a typically psoriatic pattern of arthritis, which is associated with a characteristic "pencil-in-cup" radiographic appearance of digits.
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Psoriatic arthritis involving the distal phalangeal joint.
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Arthritis mutilans (ie, "pencil-in-cup" deformities).
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Severe psoriatic arthritis showing involvement of the distal interphalangeal joints, distal flexion deformity, and telescoping of the left third, fourth, and fifth digits due to destruction of joint tissue.
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Psoriatic arthritis showing nail changes, distal interphalangeal joint swelling, and sausage digits.
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Left, typical appearance of psoriasis, with silvery scaling on a sharply marginated and reddened area of skin overlying the shin. Right, thimblelike pitting of the nail plate in a 56-year-old woman who had suffered from psoriasis for the previous 23 years. Nail pitting, transverse depressions, and subungual hyperkeratosis often occur in association with psoriatic disease of the distal interphalangeal joint. Courtesy of Ali Nawaz Khan, MBBS.
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Lateral radiograph of the cervical spine shows syndesmophytes at the C2-3 and C6-7 levels, with zygapophyseal joint fusion. Courtesy of Bruce M. Rothschild, MD.
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A 37-year-old man presents with a 1-year history of an erythematous and intensely pruritic rash at the bilateral soles of feet. He has mild dryness and fissuring at his hands, but no overlying scale, intense erythema, or itching like that at his feet. Diagnosis: Psoriatic arthritis (PsA), with palmoplantar pustulosis variant of psoriasis. Courtesy of Jason Kolfenbach, MD, and Kevin Deane, MD, Division of Rheumatology, University of Colorado Denver School of Medicine.
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Patient with psoriatic arthritis involving the joints and skin displays features of arthritis mutilans with distal interphalangeal joint destruction causing a deformity and compromise to function.
Tables
Anwar Al Hammadi, MD, FRCPC Consultant and Head of Dermatology, Rashid Hospital, Dubai Health Authority; Clinical Associate Professor of Dermatology, Dubai Medical College; Clinical Assistant Professor of Dermatology, University of Sharjah, UAE
Anwar Al Hammadi, MD, FRCPC is a member of the following medical societies: American Academy of Dermatology, Royal College of Physicians and Surgeons of Canada, Canadian Dermatology Association, Skin Cancer Foundation
Disclosure: Nothing to disclose.
Khadija Aljefri, MBChB, MSc, MRCP(UK), MRCP(Derm) Consultant Dermatologist, DermaMed Clinic; Lecturer, Dubai Medical College, UAE
Khadija Aljefri, MBChB, MSc, MRCP(UK), MRCP(Derm) is a member of the following medical societies: British Medical Association, British Association of Dermatologists, Emirates Dermatology Society, Saudi Society of Dermatology and Dermatologic Surgery
Disclosure: Serve(d) as a speaker or a member of a speakers bureau for: Galderma, Sanofi, Ego <br/>Received income in an amount equal to or greater than $250 from: Galderma, Sanofi, Ego .
Herbert S Diamond, MD Visiting Professor of Medicine, Division of Rheumatology, State University of New York Downstate Medical Center; Chairman Emeritus, Department of Internal Medicine, Western Pennsylvania Hospital
Herbert S Diamond, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, American College of Rheumatology, American Medical Association, Phi Beta Kappa
Disclosure: Nothing to disclose.
Humeira Badsha, MD Consultant Rheumatologist, Dr Humeira Badsha Medical Center, UAE
Humeira Badsha, MD is a member of the following medical societies: American College of Rheumatology, Emirates Society for Rheumatology
Disclosure: Nothing to disclose.
Bruce Buehler, MD Professor, Department of Pediatrics and Genetics, Director RSA, University of Nebraska Medical Center
Bruce Buehler, MD is a member of the following medical societies: American Academy for Cerebral Palsy and Developmental Medicine, American Academy of Pediatrics, American Association on Mental Retardation, American College of Medical Genetics, American College of Physician Executives, American Medical Association, and Nebraska Medical Association
Disclosure: Nothing to disclose.
Denise I Campagnolo, MD, MS Director of Multiple Sclerosis Clinical Research and Staff Physiatrist, Barrow Neurology Clinics, St Joseph's Hospital and Medical Center; Investigator for Barrow Neurology Clinics; Director, NARCOMS Project for Consortium of MS Centers
Denise I Campagnolo, MD, MS is a member of the following medical societies: Alpha Omega Alpha, American Association of Neuromuscular and Electrodiagnostic Medicine, American Paraplegia Society, Association of Academic Physiatrists, and Consortium of Multiple Sclerosis Centers
Disclosure: Teva Neuroscience Honoraria Speaking and teaching; Serono-Pfizer Honoraria Speaking and teaching; Genzyme Corporation Grant/research funds investigator; Biogen Idec Grant/research funds investigator; Genentech, Inc Grant/research funds investigator; Eli Lilly & Company Grant/research funds investigator; Novartis investigator; MSDx LLC Grant/research funds investigator; BioMS Technology Corp Grant/research funds investigator; Avanir Pharmaceuticals Grant/research funds investigator
Vinod Chandran, MBBS, MD, PhD Assistant Professor, Department of Medicine, Division of Rheumatology, University of Toronto Faculty of Medicine; Staff Physician, Division of Rheumatology, Toronto Western Hospital, Canada
Disclosure: Nothing to disclose.
Michael J Dans, MD, PhD Clinical Instructor, Department of Dermatology, University of California at San Francisco
Michael J Dans, MD, PhD is a member of the following medical societies: American Academy of Dermatology and American Medical Association
Disclosure: Nothing to disclose.
Dirk M Elston, MD Director, Ackerman Academy of Dermatopathology, New York
Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology
Disclosure: Nothing to disclose.
Patrick M Foye, MD Associate Professor of Physical Medicine and Rehabilitation, Co-Director of Musculoskeletal Fellowship, Co-Director of Back Pain Clinic, Director of Coccyx Pain Service (Tailbone Pain Service: www.TailboneDoctor.com), University of Medicine and Dentistry of New Jersey, New Jersey Medical School
Patrick M Foye, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Association of Neuromuscular and Electrodiagnostic Medicine, Association of Academic Physiatrists, and International Spine Intervention Society
Disclosure: Nothing to disclose.
Dafna D Gladman, MD, FRCPC Professor of Medicine, University of Toronto Faculty of Medicine; Staff Physician, Division of Rheumatology, Toronto Western Hospital, Canada
Disclosure: Nothing to disclose.
Elliot Goldberg, MD Dean of the Western Pennsylvania Clinical Campus, Professor, Department of Medicine, Temple University School of Medicine
Elliot Goldberg, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, and American College of Rheumatology
Disclosure: Nothing to disclose.
Peter D Gorevic, MD, Professor and Chief, Division of Rheumatology, Mount Sinai School of Medicine
Disclosure: Nothing to disclose.
Jeffrey M Heftler, MD Interventional Physiatrist, Orthopaedic and Neurosurgical Specialists, Greenwich, CT
Jeffrey M Heftler, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation and International Spine Intervention Society
Disclosure: Nothing to disclose.
Alexa F Boer Kimball, MD, MPH Associate Professor of Dermatology, Harvard University School of Medicine; Vice Chair, Department of Dermatology, Massachusetts General Hospital; Director of Clinical Unit for Research Trials in Skin (CURTIS), Department of Dermatology, Massachusetts General Hospital
Alexa F Boer Kimball, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, and Society for Investigative Dermatology
Disclosure: Nothing to disclose.
Kristine M Lohr, MD, MS Professor, Department of Internal Medicine, Center for the Advancement of Women's Health and Division of Rheumatology, Director, Rheumatology Training Program, University of Kentucky College of Medicine
Kristine M Lohr, MD, MS is a member of the following medical societies: American College of Physicians and American College of Rheumatology
Disclosure: Nothing to disclose.
Christen M Mowad, MD Associate Professor, Department of Dermatology, Geisinger Medical Center
Christen M Mowad, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Dermatological Association, Noah Worcester Dermatological Society, Pennsylvania Academy of Dermatology, and Phi Beta Kappa
Disclosure: Nothing to disclose.
Michael F Saulino, MD, PhD Assistant Professor, Department of Physical Medicine and Rehabilitation, MossRehab, Jefferson Medical College of Thomas Jefferson University
Michael F Saulino, MD, PhD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, Association of Academic Physiatrists, and Physiatric Association of Spine, Sports and Occupational Rehabilitation
Disclosure: Nothing to disclose.
Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference
Disclosure: Medscape Salary Employment
Abby S Van Voorhees, MD Assistant Professor, Director of Psoriasis Services and Phototherapy Units, Department of Dermatology, University of Pennsylvania School of Medicine, Hospital of the University of Pennsylvania
Abby S Van Voorhees, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, National Psoriasis Foundation, Phi Beta Kappa, Sigma Xi, and Women's Dermatologic Society
Disclosure: Amgen Honoraria Consulting; Abbott Honoraria Consulting; Merck Salary Management position; Abbott Honoraria Speaking and teaching; Amgen Honoraria Review panel membership; Centocor Honoraria Consulting; Leo Consulting; Merck None Other
Karolyn A Wanat, MD Resident Physician, Department of Dermatology, University of Pennsylvania School of Medicine
Karolyn A Wanat, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, and American Medical Women's Association
Disclosure: Nothing to disclose.
Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference
Disclosure: Nothing to disclose.
Rajesh R Yadav, MD Associate Professor, Section of Physical Medicine and Rehabilitation, MD Anderson Cancer Center, University of Texas Medical School at Houston
Rajesh R Yadav, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation
Disclosure: Nothing to disclose.