Immunosuppressants For Autoimmune Diseases

Question 1

Examples of TNF-a inhibitors

Answer 1

Etanercept
Infliximab
Adalimumab

Question 2

Which TNFa has less immunogenicity than the others? (A good thing)

Answer 2

Etanercept

Question 3

Etanercept MOA, AE

Answer 3

MOA: fusion protein, fuses TNF Receptor and Fc on IgG
Use: rheumatic syndromes
AE: activation of TB, inc infections and lymphoma in kids

Question 4

Infliximab use, MOA, AE

Answer 4

Use: IBD
MOA: MAB that neutralizes TNFa
AE: latent TB, infxn, lymphoma
Give with MTX to prevent ab formation

Question 5

Adalimumab

Answer 5

MOA: MAB against TNFa
AE: TB, infxn, basal/squamous CC

Question 6

Which drug is a IL-6 neutralizer?

Answer 6

Tocilizumab

Question 7

Toclizumab use, MOA, AE

Answer 7

Use: RA unresponsive to TNFa
MOA: blocks IL6/JAKSTAT
AE: TB, infection, GI perforation, can lead to CYP inductions

Question 8

Which drugs are B cell depletors?

Answer 8

Rituximab

Question 9

Rituximab use, MOA, AE

Answer 9

use: refractory RA, Hodgkins, CLL
MOA: MAB against CD20
AE: hep B reactivation, viral infants, fetus probs

Question 10

Which two immunosuppressants do not inc risk of TB activation?

Answer 10

Rituximab

Abatacept

Question 11

Drugs that interfere with co-stimulation?

Answer 11

Abatacept

Question 12

Abatacept use, MOA, AE

Answer 12

Use: refract RA
MOA: fusion protein that neutralizes CD80/86 on antigen presenting cells
AE: infxn, lung cancer, lymphoma

Question 13

Fxns of TNFa

Answer 13

Inc adhesion molecule expression on endothelial
Inc matrix metallopoteases released by fibroblasts
Inc chemokines released by macrophages