Therapies For RA Flashcards
What is point of DMARDs?
Slow the clinical and radio graphic progression of RA
Targeted synthetic DMARDs?
JAK inhibitorsL tofacitinib
Baricitinib
Synthetic DMARDs?
MTX, sulfasalazine, hydroxychloroquine, leflunomide
Biological agents?
TNF blockers
Drugs targeting IL 1 IL6 B cells and T cells
Methotrexate increase?
Adenosine level, anti inflammatory
Methotrexate induced the apoptosis of?
CD4/8
What are side effects of DMARDs?
Risk of infections
Hepatoxicity
Kidney toxicity
Headache
Side effect of hydroxychloroquine?
Accumulation of drug in eye e.g Retinal pigment epithelium atrophy
What is side effect of leflunomide?
Hypertension
Tofacitinib role?
Selectively inhibits JAk1 and JAK 3
Used for psoriatic arthritis
UC
Baricitinib role?
Selectively and reversible inhibits JAK 1 and 2
Adverse effects of synthetic targeted DMARDs?
Increased risk of infection, fatigue fever, GI problems, thrombocytosis, herpes zoster
Research in biological study showed?
Anti TNF alpha antibody reduced IL 1 production
Il8 help with?
Leukocyte adhesion and diapedesis
IL6 helps with?
Cartilage degradation
Which are the TNF blockers?
Infliximab etanercept, adalimumab
Which drug is a monoclonal antibody against B cells?
Rituximab
Which is IL 1R antagonist?
Ankinra
Etanercept?
TNF receptor. Reduces accessible TNF
Certolizumab pegol?
No Fc portion attached to polyethylene glycol to reduce immunogenicity, prolong circulatory time
ANTi TNF therapy, side effects
Increased risk of infections TB
Live vaccines
What percent of RA patients don’t respond to ANTi- TNF medication/ MTX?
30
Rituximab- B cell depleting agent does what?
Opsonises B cells so
- Complement mediated toxicity
- Antibody dependent cell mediated cytotoxicity/ phagocytosis
- Apoptosis
Used for SLE
Abatacept role?
Prevents costimulation, competitive inhibitor of CD28, binds CD80
Adverse effects of biologics?
increased risk of infections
Not advised on:
Avoid live vaccines
Hypertension
Allergic reactions
