Biological DMARDS

Question 1

T cell modulator
Inhibits activation of T cells

Adverse: increased risk of URTI

Answer 1

Abatacept

Question 2

B cell cytotoxic agent
Chimeric monoclonal antibody

Targets CD20 lymphocytes
Decreased B cell results in decreased inflammation

Adverse: rashes and infections

Answer 2

Rituximab

Question 3

Anti IL6 antibody

For moderate to sever RA

Adverse: URTI, headache, HTN, inc liver enzymes

Answer 3

Tocilizumab

Question 4

Fully human IgG, anti TNF antibody resulting in downregulation of macrophage and T cell function

Indications: RA, Crohns( effective as monotherapy)

Adverse: infections

Answer 4

Adalimumab

Question 5

Anti TNF alpha
Inhibits lymphotoxin alpha

Injected subcutaneously

Adverse: bacterial infections( soft tissue and septic arthritis)

Answer 5

Etanercept

Question 6

Anti TNF alpha
Neutralizes its effect

Same indication and adverse effect with etenercept

Answer 6

Golimumab

Question 7

Anti TNF alpha
Chimeric IgG monoclonal antibody

IV induction at 0,2,6 weeks and every 8 weeks

Same indications and adverse

Answer 7

Infliximab

Question 8

Anti TNF alpha
Neutralize membrane bound and soluble TNF in dose dependent manner

Adverse: lymphomas

Answer 8

Certolizumab