Biologics

Question 1

Name the TNF-alpha inhibitors and their routes of administration:

Answer 1

• Adalimumab- sub Q
• Etanercept- sub Q
• Infliximab- IV

“A,E,I”

Question 2

TNF alpha inhibitors are pregnancy category ____

Answer 2

• B

Question 3

Infliximab commonly causes _____ reactions

Answer 3

• infusion reactions (headaches, flushing, dyspnea, taste perversion)

Question 4

how to avoid infliximab infusion reaction?

Answer 4

• slowly infuse and premedicate

Question 5

psoriasis, palmoplantar pustolosis, and cutaneous vasculitis have been reported with which class of biologics?

Answer 5

• TNF alpha inhibitors

Question 6

Labs to check prior to starting TNF alpha inhibitors:

Answer 6

• PPD/quant gold
• viral hepatitis panel
• liver enzymes

Question 7

Ustekinumab MOA:

Answer 7

• binds p40 subunit of IL-12 and IL-23

“usTekinumab”= Twelve and Twenty Three”

Question 8

Rituximab MOA:

Answer 8

• targets CD20 (B-cell surface antigen)

Question 9

Name the IL-17 inhibitors and their exact MOA’s with relation to IL-17:

Answer 9

• Ixekizumab and secukinumab: neutralize IL-17A
• Brodalumab antagonizes the IL-17 receptor (Bros always be antagonizing the IL-17 receptor)
• Ixe and secu are neutral, but the bro is the antagonizer

Question 10

TNF alpha inhibitors have an increased risk of which cancer?

Answer 10

• lymphoma

Question 11

Biologic class that has shown best results for psoriasis tx?

Answer 11

• IL-17 inhibitors (Ixe, Secu, Brodalumab)

Question 12

Most common AE of IL-17 inhibitors:

Answer 12

• nasopharyngitis

Question 13

Omalizumab MOA and use in derm:

Answer 13

• monoclonal anti-IgE antibody

Question 14

• Guselkumab MOA:

- other biologic with same MOA?

Answer 14

• binds p19 subunit of IL-23

- Tildrakizumab

Question 15

MOA of Tildrakizumab:

- other biologic with same MOA?

Answer 15

• binds p19 subunit of IL-23
• Guselkumab

“G + T bind IL-23”