week 5 part 2 Flashcards
Where is technology going from?
- Rodent
- Chimeric
- Humised
- Human
more human like and less immunogenic
What is haemophilia caused . by?
Failure to produce certain proteins required for blood clotting
- Factor VIII (haemophila A)
- Factor IX (haemophila B)
How many Haemophila A be restored?
Infusion of recombinant FVIII
How does the body make inhibitory antibodies?
If you are haemophila A type and you’ve never made factor 8
You’ve been given recombinant protein
Why do we change treatment?
To give pre-formed complexes to help the cascade
What are Lysosomal storage disorder?
- Inherited disorder resulting from a lack of specific enzymes that break down certain lipids (fats) or carbohydrates (sugars) in body cells
What disrupts normal function and cause lysosomal storage disorder?
If a person does not have enough of one of these enzymes, the body cannot break down the fat or carbohydrate targeted by enzymes for recycling. These fats or sugars accumulate in cell lysosomes where enzymes are active
What does Enzyme replacement therapy involve?
Intravenous infusion to correct the underlying enzyme deficiency that causes symptoms of Gaucher disease
What is the enzyme replacement therapy drug for Gaucher’s?
Cerezyme
What is the enzyme replacement therapy drug for Fabry’s disease?
Fabrazyme
What is Myozyme used to treat?
Patient who have Pompe disease
A rare inherited disorder
What do patients with pome disease do not have enough of?
Enzyme - alpha glucosidase
Breaks down sugar stored as glycogen into glucose that can be used for energy by the body’s cells
What is the first enzyme replacement therapy to specifically treat the underlying cause of MPS1?
Aldurazyme (Iaronidase)
What is Infliximab?
The active ingredient in REMICADE
- A chiemric IgG1K monoclondal antibody specific for human tumour necrosis factor alpha (TNFalpha)
What is the molecular weight of Infliximab?
149.1 kilodaltons
What is Infliximab produced by?
Recombinant cell line cultured by continuous perfusion and is purified by a series of steps that includes measures to inactivate and remove viruses
What did patients with tuberculosis frequently presented with?
Disseminated or extrapulmonary disease
What should patients be tested for before Remicade use and during therapy?
Latent tuberculosis
When should treatment for latent infection be initiated?
prior to REMICADE use
What is Alemtuzumab used for?
MS
Drug is given 5 days in a row for the first ear
Then exactly a year later - 3 days in a row
In subsequent years -3 more days
What are the cost for Alemtuzumab?
First year - around 35,000
Second year - 21,000
What is Lemtrada?
CD52-directed cytolytic monoclonal antibody indicated for the treatment of patients with relapsing forms of multiple sclerosis (MS)
What does Alemtuzumab bind to?
Cb52 which is on B cells or NK cells
Depletes your lymphocytes
come of treatment: secondary autoimmune conditions
Deplete CD4 regulatory cells
Alemtuzumab
a monoclonal antibody that targets an antigen known as CD52, a common antigen found on B and T cells (part of the body’s immune system). When the alemtuzumab antibody attaches to the CD52 antigen, the body’s immune system is activated to destroy these targeted cells in the blood and bone marrow. Since the CD52 antigen is also present on healthy B and T cells, however, treatment will temporarily weaken your immune system and care must be taken to protect you from infection during treatment
What is Adalimumab (Humira)?
is an anti-TNF drug. In rheumatoid arthritis and some other conditions, too much of a protein called TNF (tumour necrosis factor) is produced in the body, causing inflammation, pain and damage to the bones and joints. Anti-TNF drugs such as adalimumab block the action of TNF and so reduce this inflammation
Where was anti-adalimumab detected?
76 patients (28%)
♣ Shows that 51 of 76 patients (67% of antiadalimumab antibody−positive patients) developed antiadalimumab antibodies during the first 28 weeks of treatment
What is Natalizumab?
A humanized monoclonal antibody against the cell adhesion molecule alpha-4 integrin
What is Natalizumab used in?
Treatment of multiple sclerosis and Chrohn’s disease
How is Natalizumab administered?
Intravenous infusion every 28 days
Works by reducing the ability of inflammatory immune cells to attach to and pass through the cell layers lining the intestine and BBB
Why was Natalizumab withdrawn from the market?
linked with three cases of the rare neurological condition progressive multifocal leukoencephalopathy (PML)
Why didnt the FDA not withdraw Natalizumab from market?
Clinical benefit outweighs the risk involved
What is Rituximab?
Targets the CD20 antigen on normal and malignant B cells
The body’s natural immune defences are recruited to attack and kill the marked B cells
Stem cells do not have the CD20 antigen
This allows healthy B-cells to regenerate after treatment
How does Ocrelizumab work by?
Targeting a type of immune cell
This helps to reduce the immune response by stopping these cells from attacking and damaging myelin
