Rheum- RA (Biologics) Flashcards
What are biologic agents?
•Genetically engineered protein molecules block the proinflammatory cytokines
What are the 4 different groups of biologic agents?
–TNF-α (Adalimumab, etc)
–IL-6 (Tocilizumab, etc)
–Deplete B cells (Rituximab)
–Bind to CD80/86 on T cells to prevent activation of T cells (Abatacept)
What are the 5 TNF-α biologic agents?
- Adalimumab
- Certolizumab
- Etanercept
- Golimumab
- Infliximab
What are the names of the 2 IL-6 biologics?
- Tocilizumab
- Sarilumab
What is the mechanism of the TNF-α biologic DMARDS?
–Block the proinflammatory cytokins TNF-α
What is the 1 contraindication of the TNF-α biologic DMARDs?
(KNOW)
CHF
The following are the ADEs of which group of biologic DMARDs?
–MS-like illness or exacerbate MS
–Increased risk of lymphoproliferative cancer
TNF-α Biologics
(limumab, Certolizumab, Entanercept, Golimumab, Infliximab)
Which TNF-α Biologic DMARD?
- Fusion protein
- Binds to TNF making it biologically inactive
Etanercept
Which TNF-α biologic DMARD?
- Chimeric antibody combining portions of mouse and human IgG1
Infliximab
What should be given concurrently w/ Inliximab?
Oral methotrexate
What are the 3 uses of Golimumab (TNF-α biologic)
- RA
- Psoriatic arthritis
- Ankylosing spondylitis
The two IL-6 biologic DMARDS, Tocilizumab and Sarilumab, should be used in monotherapy or in combo with either of what 2 meds?
methotrexate or another non-biologic DMARD
ADEs of which biologic?
- Increased infection risk
- Elevated plasma lipids
- Elevated liver enzymes
- Risk of GI perforation
- Inducer of CYP450 3A4 (warfarin)
IL-6: Tocilizumab and Sarilumab
Should live vaccines be given during RA treatment with any of the biologics?
NO
______ should be continued wtih Rituximab
Methotrexate
