TNF inhibitors Flashcards
Infliximab (Remicade) indications
UC and CD
Infliximab places in therapy
Induction and maintenance
May be preferred for UC induction
Option for fulminant UC
Infliximab ADRs
Increase risk of infection
Injection site reactions and infusion related reactions
Risk of lymphoma
HSTCL risk
Risk of demyelinating disease
May exacerbate CHF
TNF class monitoring
CXR, PPD
Hep B,C
SCr, lytes
LFTs
UA
CBC
S/Sx of infection
Vitals (each dose)
Infusion reactions (each dose)
TDM (consider if tx failure)
Infliximab pearls
requires infusion
may combine with thiopurines/MTX to increase efficacy, decrease ADA
ensure vaccinations are up to date, live vaccination c/o
Adalimumab indications
UC and CD
Adalimumab place in therapy
Mod-severe active CD and UC
Steroid-dependent
Pts with poor response to infliximab
Induction and maintenance therapy
Adalimumab ADRs
Class ADRs
Administration specific
Development of ADAs
Adalimumab monitoring
Class monitoring
TDM possible (target through > or equal to 8-12 ug/dL
Golimumab indications
UC
Golimumab place in therapy
Mod-severe active UC
Steroid-dependent
Induction and maintenance therapy
Golimumab ADRs
Class ADRs
Administration specific
Development of ADAs
Golimumab monitoring
Class monitoring
TDM possible: >2.5-3.8 μg/ml (week 6) and >1.4-2.4 μg/ml (maintenance)
Certolizumab indications
CD
Certolizumab place in therapy
Mod-severe active CD
Steroid-dependent
Induction and maintenance therapy
