Biologics

Question 1

TNF alpha
Etanercept
Adlimumab
Infliximab
Adverse effects

Answer 1

1. Exacerbates CHF
2. Increased risk for demyelinating disease

-can use in combo with MTX

Question 2

Abatacept MOA

Answer 2

is a CTLA4 IgG fusion protein

1. binds cd80/86
2. now CD28 cant bind
3. now T cell not active

Question 3

Do you combine biologics? Can they increase risk of infection and should you screen for latent Tb and HPV

Answer 3

NO

YES

Question 4

Anakinra

MOA

Answer 4

blocks IL-1R
less effective than anti-tnf alpha
short HL 4-6 hours
sub Q- once per day

Question 5

Tocilizumab
MOA
Adverse

Answer 5

humanized anti-il6r mAB
-blocks Il 6 signaling

1. Hepatotoxicity
2. Hypercholesterolemia
3. BM suppression
4. increased risk for malignancy
5. Monitor for demyelinating

Question 6

Tofacitinib

MOA

Answer 6

Inhibits JAK kinase
-blocks immune cytokine signaling

1. Hepatotoxicity
2. Hypercholesterolemia
3. Lipid abnormalities
4. BM suppression

Question 7

Rituximab

Answer 7

Binds to CD20 on B cells
IV infusion -depletes b cells

PML-progressive multifocal Leukoencephalopathy-reactivation of JC virus