Biologics Flashcards
(16 cards)
What are the pharmacokinetic characteristics of TNF-C, Alefacept, Ustekinumab, Rituximab, IVIG, and Omalizumab?
Detailed in the relevant literature
Their label (approved) and off-label (unapproved) indications have been defined.
What is the main role of TNF-a in the immune response?
Recruitment of immune cells to the cutaneous micro-environment
TNF-a also induces secretion of metalloproteinases and pro-inflammatory cytokines.
What is the mechanism of action of TNF-a antagonists?
Block binding of TNF-a to its receptors, interrupting signaling pathways
This helps in reducing inflammation.
What is Infliximab and how does it function?
A chimeric antibody that binds and neutralizes both sTNF and tmTNF
It also fixes complement and induces cell apoptosis.
What is the initial dosing protocol for Infliximab?
5 mg/kg at 0, 2, and 6 weeks, then every 8 weeks for maintenance
No systemic accumulation occurs upon continued treatment.
What is Adalimumab and its primary mechanism?
A fully human monoclonal anti-TNF-a antibody that binds sTNF-a
It prevents interaction with TNFR1 and TNFR2 receptors.
What is the dosing schedule for Adalimumab?
80 mg subcutaneously initially, followed by 40 mg every other week
Therapy should be reconsidered if no response is observed within 16 weeks.
What is Etanercept and how does it work?
A fusion protein that binds sTNF-a, preventing its receptor interaction
It alters the cytokine pattern in the immune response.
What are Golimumab and Certolizumab?
Golimumab is a human monoclonal antibody to TNF-a; Certolizumab is a PEGylated Fab fragment
Both are approved for rheumatoid arthritis and show efficacy in psoriatic arthritis.
What is Ustekinumab’s mechanism of action?
Binds to the p40 protein subunit of IL-12 and IL-23, preventing their receptor interaction
This inhibits activation of NK cells and CD4+ T-cell differentiation.
Fill in the blank: The term ‘biologic’ refers to agents synthesized from the _______.
products of living organisms
True or False: The safety profile of biologics is generally considered less favorable than traditional immuno-suppressive agents.
False
What are the adverse reactions associated with biologics?
Some are associated with significant morbidity
Initial enthusiasm has shifted to a more cautious approach.
What is the significance of the literature on individual anti-TNF drugs?
Each drug is mentioned separately due to differing actions and efficacy in diseases
Limitations for their use have also been discussed.
What is the role of TNF receptors in the immune response?
They activate NF-kB, promoting inflammation and apoptosis
TNF receptors are primarily located on keratinocytes, neutrophils, endothelial cells, and fibroblasts.
