Lecture 3 - Drugs for Autoimmune Disease Flashcards
Entercept
immunosuppresant
useful for many rheumatic syndromes
thought to be less effective against IBDs compared to other TNF alpha inhibitors
MOA:
TNF - alpha blocking agent
fusion protein (fusion of TNF receptor and Fc domain of IgG) that neutralizes TNF alpha
SE:
activation of latent TB
increased opportunistic infections
avoid in pts with recent malignancies
less immunogenic than other TNF-alpha blocking agents
often combined with other traditional DMARDs (methotrexate, azathioprine, cyclosporine)
What is the MOA of etancercept?
TNF - alpha blocking agent fusion protein (fusion of TNF receptor and Fc domain of IgG) that neutralizes TNF alpha
What are the SE of entanercept?
activation of latent TB
increased opportunistic infections
avoid in pts with recent malignancies
Adalimumab
immunosuppressant
useful for RA, ulcerative colitis, Crohn’s disease
MOA: TNF-alpha blocking agent
human monoclonal antibody that neutralizes TNF -alpha
SE:
activation of latent TB
increased opporuntistic infection
avoid in pts with recent malignancies
associated with basal cell and squamous cell skin cancers
often combined with other traditional DMARDs
concurrent therapy with methotrexate to prevent antibody formation against adalimumab
What is the indication for adalimumab?
immunosuppressant
useful for RA, ulcerative colitis, Crohn’s disease
What is the MOA of adalmumab?
TNF-alpha blocking agent
human monoclonal antibody that neutralizes TNF -alpha
What are the SE of adalmumab?
activation of latent TB
increased opporuntistic infection
avoid in pts with recent malignancies
associated with basal cell and squamous cell skin cancers
Infliximab
immunosuppresant
useful for RA, UC, Crohn’s disease
MOA:
TNF alpha blocking agent
chimeric human/mouse monoclonal antibody that neutralizes TNF-alpha
SE:
activation of latent TB
increased opportunistic infections
avoid in pts with recent malignancies
often combined with other traditional DMARDs
concurrent therapy with methotrexate to prevent antibody formation against infliximab
What is the indication for infliximab?
immunosuppresant
useful for RA, UC, Crohn’s disease
What is the MOA of infliximab?
TNF alpha blocking agent
chimeric human/mouse monoclonal antibody that neutralizes TNF-alpha
What are the SE of infliximab?
activation of latent TB
increased opportunistic infections
avoid in pts with recent malignancies
Tocilizumab
immunosuppressant
used for RA in pts unresponsive to TNF alpha inhibitors
MOA:
humanized monoclonal antibody that neutralizes IL-6 receptor on immune cells
SE:
activation of latent TB
increased opportunistic infections
GI perforation
suppression of IL-6 receptor can lead to induction of CYP2C9, 2C19, @d6, 3A4
plasma levels of drugs metabolized by these enzymes are typically decreased by tocilizumab
What is the indication for tocilizumab?
immunosuppressant
used for RA in pts unresponsive to TNF alpha inhibitors
What is the MOA for tocilizumab?
humanized monoclonal antibody that neutralizes IL-6 receptor on immune cells
What are the SE of tocilizumab?
activation of latent TB
increased opportunistic infections
GI perforation