Immunotherapy - Dra. Viterbo Flashcards
(180 cards)
1
Q
3 main components of Innate Immune System
A
- MECHANICAL COMPONENTS (skin/epidermis, mucus)
- BIOCHEMICAL COMPONENTS (antimicrobial peptides and proteins, complement, enzymes, interferons, acidic pH, free radicals)
- CELLULAR COMPONENTS (neutrophils, macrophage, NK, NKT)
2
Q
Complement components enhance macrophage and neutrophil phagocytosis by?
A
By acting as opsonins (C3b) and chemoattractants (C3a, C5a) to recruit immune cells and ultimately lead to pathogen lysis via generation of MAC
3
Q
3 mediators of influx of neutrophils and monocytes toward inflammation site
A
All released by activated endothelial cells and immune cells at inflam site:
- IL-8 and CXCL 8 (chemoattractant cytokines/chemokines)
- MCP-1, CCL-2
- MIP-1a, CCL-3
4
Q
Mediates egress of immune cells from BV into the inflammatory site
A
Adhesive interactions between cell surface receptors (L-selectin, integrin) on immune cells and ligands (sialyl-Lewis x, ICAM-1)
5
Q
These include TLRs, NLRs., scavenger receptors, mannose receptors and LPS-binding CHON that recognize PAMPs
A
Pattern Recognition Receptors
6
Q
These stimulate the release of proinflammatory cytokines, chemokines, and interferons upon recognition of PAMPS
A
PRRs
7
Q
3 cells that secrete IFN-y and IL-17
A
NK cells
NKT cells
gamma-delta T cells
8
Q
Activates resident tissue macrophages and dendritic cells
A
IFN-y
9
Q
Recruits neutrophils
A
IL-17
10
Q
Cells that are able to recognize and destroy virus infected
normal cells as well as tumor cells without prior stimulation.
A
NK cells
11
Q
Receptors that deliver inhibitory signals to NK cells to prevent them from killing normal cells
A
Killer Cell Ig-like Receptors on NK cells surface (specific for MHC 1 molecules)
12
Q
How do NK cells kill target cells?
A
By releasing cytotoxic granules (perforins, granzymes)
13
Q
Cells that recognize microbial lipid
antigens presented by a CD1 and have been implicated in host defense against
microbial agents, autoimmune diseases, and tumors.
A
NKT cells
14
Q
Unique characteristics of Adaptive Immune System
A
- Respond to a variety of antigens in a specific manner
- Can discriminate between self and non self
- Responds to a previously encountered antigen
15
Q
Effectors of humoral immunity
A
Antibodies
16
Q
Effectors of cell-mediated immunity
A
T lymphocytes
17
Q
What are the APCs that induce adaptive immunity?
A
Dendritic cells
Macrophages
B lymphocytes
18
Q
Explain how APCs function.
A
APCs phagocytose/endocytose pathogens or protein antigens > generate peptides after enzymatic digestion > loaded to class 1 or 2 MHC > presented to cell surface TCR
19
Q
MHC recognized by CD8 T cells
A
MHC Class I
20
Q
MHC recognized by CD4 T cells
A
MHC Class II
21
Q
2 signals for T cell activation
A
- TCR + peptide-bound MHC molecules
2. Ligation (binding) of costimulatory molecules on APC to their respective ligands
22
Q
Regulates activation of T cells
A
CTLA-4 (T-lymphocyte associated antigen)
CTLA-4 is mobilized to the cells surface after CD28 is engaged to CD80 or CD86. CTLA-4 displaces CD28 resulting in suppression of T-cell activation and proliferation
23
Q
A recombinant
humanized antibody that binds CTLA-4 and prevents
its association with CD80/CD86.
A
ipilimumab, anti-CTLA-4 antibody
24
Q
AE associated with ipilimumab
A
autoimmune toxicity
25
lymphocytes develop and learn to recognize self and non-self
| antigens in the?
Thymus
26
A process by which T cells bind with high affinity
| to self antigens in the thymus undergo apoptosis.
Negative selection
27
Strengthen activation signals between APCs and T lymphocyte
CD40/CD40L and ICAM-1/LFA-1 interactions
28
A process by which T lymphocytes recognize foreign antigens in the
presence of self MHC molecules and are retained and expanded for export to the periphery
Positive selection
29
Produced by TH1 cells
IFN-y
IL-2
IL-12
30
How do TH1 cells induce cell-mediated
| immunity?
by activation of macrophages, cytotoxic T cells (CTLs),
| and NK cells
31
Produced by TH2 cells
```
IL-4
IL-5
IL-6
IL-10
IL-13
```
32
How do TH2 cells induce cell-mediated
| immunity?
by inducing B-cell proliferation
| and differentiation into antibody-secreting plasma cells
33
Produced by TH2 cells to inhibit cytokine production by TH1 cells
via the down-regulation of MHC expression by APCs
IL-10
34
Produced by TH1 cells inhibits the proliferation of TH2 cells.
IFN-y
35
Causes the elaboration of TH2 cytokines for the production of neutralizing and opsonic antibodies
extracellular bacteria
36
Elicit the production of TH1 cytokines
Intracellullar bacteria
37
Subsets of helper T cells
TH1 and TH2
38
Produces transforming growth factor-β (TGF-β),
whose numerous functions include down-regulation of proliferation
and differentiation of T lymphocytes
TH3
39
A population of CD4 T cells that is essential for preventing
autoimmunity and allergy as well as maintaining homeostasis and
tolerance to self antigens.
regulatory T cell (Treg) T cell
40
Involves retro-translocation of antigens from
the endosome to the cytosol for peptide generation in the proteosome
and is thought to be useful in generating effective immune
responses against infected host cells that are incapable of priming
T lymphocytes
Cross-presentation
41
Ways by which CD8 induce target cell death
1. Granzymes
2. Perforins
3. Fas-FasL apoptosis pathway
42
The repertoire of antigen specificities by T cells is
| genetically determined and arises from?
T-cell receptor gene rearrangement
43
The specificities of B cells arise from ?
immunoglobulin
| gene rearrangement
44
```
A matrure B cell binds the antigen, internalizes
and processes it, and presents its peptide—bound to class
II MHC—to?
```
CD4 helper cells
45
CD4 helper cells secrete ___ to stimulate B-cell differentiation into memory B cells and antibody-secreting plasma cells
IL-4
| IL-5
46
How do antiodies mediate their functions?
Antibodies mediate their functions by acting as opsonins to
enhance phagocytosis and cellular cytotoxicity and by activating
complement to elicit an inflammatory response and induce bacterial
lysis.
47
A purified adenosine deaminase from a bovine source used in the management of Severe Combined Immunodeficiency Syndrome
Pegademase
48
first hormonal agents
| recognized as having lympholytic properties
Glucocorticoids (corticosteroids)
49
Contact
hypersensitivity mediated by T DTH cells is usually
abrogated by?
glucocorticoid therapy
50
ID Immunosuppressive Agent used: Acquired factor XIII antibodies
Cyclophosphamide plus factor XIII
51
ID Immunosuppressive Agent used: Acute glomerulonephritis
Prednisone, mercaptopurine, cyclophosphamide
52
ID Immunosuppressive Agent used: Liver Organ transplantation
Cyclosporine, prednisone, azathioprine, tacrolimus, sirolimus
53
ID Immunosuppressive Agent used: Bone Marrow Organ transplantation
Cyclosporine, cyclophosphamide, prednisone, methotrexate, ALG
54
ID Immunosuppressive Agent used: Prevention of cell proliferation
Coronary stents
Sirolimus (impregnated stent)
55
ID Immunosuppressive Agent used: Prevention of cell proliferation Neovascular macular degeneration
Ranibizumab (labeled), bevacizumab (off-label)
56
first-line immunosuppressive therapy for both solid
| organ and hematopoietic stem cell transplant recipients
Glucocorticoids (corticosteroids)
57
Peptide antibiotic that appears to act
at an early stage in the antigen receptor-induced differentiation of
T cells and blocks their activation
Cyclosporine (cyclosporin A, CSA)
58
MOA of Cyclosporine (cyclosporin A, CSA)
```
Cyclosporine binds to cyclophilin
, a member of a class of intracellular proteins called immunophilins.
```
Cyclosporine and cyclophilin form a complex that
inhibits the cytoplasmic phosphatase, calcineurin, which is necessary
for the activation of a T-cell-specific transcription factor. This
transcription factor, NF-AT, is involved in the synthesis of interleukins
(eg, IL-2) by activated T cells.
59
ophthalmic
| solution of this drug is now available for severe dry eye syndrome and ocular graft-versus-host disease
Cyclosporine (cyclosporin A, CSA)
60
Inhaled form of this drug is being
| investigated for use in lung transplantation.
Cyclosporine (cyclosporin A, CSA)
61
This immunosuppressive agent causes nephrotoxicity, hypertension,
hyperglycemia, liver dysfunction, hyperkalemia, altered
mental status, seizures, and hirsutism.
Cyclosporine (cyclosporin A, CSA)
62
This immunosuppressive agent causes increased incidence
of lymphoma and other cancers (Kaposi’s sarcoma, skin
cancer)
Cyclosporine (cyclosporin A, CSA)
63
This immunosuppressive agent induces
| TGF-β, which promotes tumor invasion and metastasis.
Cyclosporine (cyclosporin A, CSA)
64
sole immunosuppressant for cadaveric transplantation
of the kidney, pancreas, and liver, and it has proved extremely
useful in cardiac transplantation as well
Cyclosporine (cyclosporin A, CSA)
65
A standard prophylactic regimen to
| prevent graft-versus-host disease after allogeneic stem cell transplantation
Cyclosporine (cyclosporin A, CSA) + methotrexate
66
an immunosuppressant macrolide antibiotic
| produced by Streptomyces tsukubaensis
Tacrolimus (FK 506)
67
Cyclosporine (cyclosporin A, CSA) and Tacrolimus (FK 506) bind to which enzymes?
cytoplasmic peptidylprolyl isomerases
68
Calcineurin Inhibitors
Cyclosporine (cyclosporin A, CSA) and Tacrolimus (FK 506)
69
While cyclosporine binds to cyclophilin,
| tacrolimus binds to the?
immunophilin FK-binding protein
| FKBP
70
now considered a standard prophylactic agent
(usually in combination with methotrexate or mycophenolate
mofetil) for graft-versus-host disease
Tacrolimus (FK 506)
71
Cyclosporine and Tacrolimus are primarily metabolized by the ____ enzyme system in the
liver with resultant multiple drug interactions
P450 3A
72
Its
toxic effects include nephrotoxicity,
neurotoxicity, hyperglycemia, hypertension, hyperkalemia,
and gastrointestinal complaints.
Tacrolimus (FK 506)
73
currently used in the therapy of atopic
| dermatitis and psoriasis
Tacrolimus ointment
74
mTOR inhibitors analogs (called “rapalogs”)
everolimus and temsirolimus
75
an immunosuppressant macrolide antibiotic produced
| by Streptomyces hygroscopicus and is structurally similar to tacrolimus
Sirolimus
76
Sirolimus binds the _________, resulting in an active complex that inhibits the
kinase activity of mammalian target of rapamycin (mTOR)
circulating immunophilin FK506-
| binding protein 12
77
Has been used effectively alone and in combination
with other immunosuppressants (corticosteroids, cyclosporine,
tacrolimus, and mycophenolate mofetil) to prevent rejection of
solid organ allografts
Sirolimus
78
5 drugs used to to prevent rejection of
| solid organ allografts
```
Sirolimus
corticosteroids
cyclosporine
tacrolimus
mycophenolate mofetil
```
79
used as prophylaxis and as therapy for
steroid-refractory acute and chronic graft-versus-host disease in
hematopoietic stem cell transplant recipients.
Sirolimus
80
used in some dermatologic disorders and, in combination
| with cyclosporine, in the management of uveoretinitis
Sirolimus
81
Toxicities can include profound
myelosuppression (especially thrombocytopenia), hepatotoxicity,
diarrhea, hypertriglyceridemia, pneumonitis, and headache.
mTOR inhibitors
82
Because nephrotoxicity is of major concern when administering
calcineurin inhibitors, _____ is frequently employed as firstline
immunosuppressant therapy in both solid organ and stem
cell transplantation because renal toxicity is usually not seen
sirolimus
83
When combined
with tacrolimus, has revealed an increased incidence of hemolytic-
uremic syndrome.
sirolimus
84
a semisynthetic derivative of mycophenolic acid, isolated from the mold Penicillium glaucus .
Mycophenolate mofetil (MMF)
85
used in solid organ transplant
| patients for refractory rejection
Mycophenolate mofetil (MMF)
86
Its antiproliferative properties
make it the first-line drug for preventing or reducing chronic
allograft vasculopathy in cardiac transplant recipients.
Mycophenolate mofetil (MMF)
87
used as prophylaxis for and treatment of
both acute and chronic graft-versus-host disease in hematopoietic
stem cell transplant patients
Mycophenolate mofetil (MMF)
88
```
Toxicities include gastrointestinal disturbances (nausea and
vomiting, diarrhea, abdominal pain) headache, hypertension, and
reversible myelosuppression (primarily neutropenia).
```
Mycophenolate mofetil (MMF)
89
inhibits
angiogenesis and has anti-inflammatory and immunomodulatory
effects
Thalidomide
90
It inhibits tumor necrosis factor-alpha (TNF-α), reduces
phagocytosis by neutrophils, increases production of IL-10, alters
adhesion molecule expression, and enhances cell-mediated immunity
via interactions with T cells.
Thalidomide
91
currently used in the treatment of multiple
| myeloma at initial diagnosis and for relapsed-refractory disease.
Thalidomide
92
Thalidomide is combined with what drug to increase response rate to myeloma by 90%?
Dexamethasone
93
has been used
for many years in the treatment of some manifestations of leprosy
and has been reintroduced in the USA for erythema nodosum
leprosum
Thalidomide
94
it is also useful in management of the skin manifestations
| of lupus erythematosus
Thalidomide
95
adverse effects include peripheral
neuropathy, constipation, rash, fatigue, hypothyroidism, and
increased risk of deep vein thrombosis
Thalidomide
96
effectivene in the treatment of the myelodysplastic
| syndrome with the chromosome 5q31 deletion
Lenalidomide
97
Advantages of lenalidomide over thalidomide
less teratogenic effect and
| fewer thromboembolic event
98
another
oral IMiD that is being investigated for the treatment of multiple
myeloma and myelodysplasia
Pomalidomide (CC4047)
99
```
The only IMiD currently used as an
immunosuppressive medication (ie, in transplant recipients)
```
thalidomide
100
prodrug of mercaptopurine and, like mercaptopurine,
| functions as an antimetabolite
CYTOTOXIC AGENT: Azathioprine
101
Azathioprine has significant drug interaction with?
Allopurinol
Much of the drug’s
inactivation depends on xanthine oxidase
102
MOA CYTOTOXIC AGENT: Azathioprine
Azathioprine and mercaptopurine appear to produce immunosuppression
by interfering with purine nucleic acid metabolism at
steps that are required for the wave of lymphoid cell proliferation
that follows antigenic stimulation.
103
MOA CYTOTOXIC AGENT: Azathioprine
destroy stimulated lymphoid cells
104
management of acute glomerulonephritis
| and in the renal component of systemic lupus erythematosus
CYTOTOXIC AGENT: Azathioprine
105
proved useful in some cases of rheumatoid
| arthritis, Crohn’s disease, and multiple sclerosis
CYTOTOXIC AGENT: Azathioprine
106
have
been of occasional use in prednisone-resistant antibody-mediated
idiopathic thrombocytopenic purpura and autoimmune hemolytic
anemias
CYTOTOXIC AGENT: Azathioprine
107
The chief toxic effect of azathioprine and mercaptopurine is?
bone marrow suppression, usually manifested as leukopenia,
| although anemia and thrombocytopenia may occur
108
Hepatic dysfunction, manifested by very high serum alkaline
| phosphatase levels and mild jaundice, occurs occasionally in which cytotoxic agent?
Azathioprine
109
The alkylating agent that destroys proliferating lymphoid cells
Cyclophosphamide
110
Effective against acquired factor XIII
antibodies and bleeding syndromes, autoimmune hemolytic anemia,
antibody-induced pure red cell aplasia, and Wegener’s granulomatosis
Cyclophosphamide
111
Treatment with large doses of cyclophosphamide carries considerable
risk of?
pancytopenia and hemorrhagic cystitis
112
prodrug of an inhibitor of pyrimidine synthesis approved only for rheumatoid
arthritis at present
Leflunomide
113
Toxicities include elevation of liver enzymes with some risk of
liver damage, renal impairment, and teratogenic effects.
Leflunomide
114
```
an antimalarial agent thought to suppress intracellular antigen
processing and loading of peptides onto MHC class II molecules
by increasing the pH of lysosomal and endosomal compartments,
thereby decreasing T-cell activation.
```
Hydroxychloroquine
115
The antibiotic ____ has
also been used with some success at the time of impending renal
transplant rejection
dactinomycin
116
appears to be quite useful in
| idiopathic thrombocytopenic purpura refractory to prednisone
Vincristine
117
has been shown to prevent
mast cell degranulation in vitro by binding to microtubule
units within the cell and to prevent release of histamine and
other vasoactive compounds
vinblastin
118
adenosine deaminase inhibitor primarily
used as an antineoplastic agent for lymphoid malignancies, and
produces a profound lymphopenia
Pentostatin
119
Acts primarily on the small, long-lived peripheral lymphocytes causing an impairment of delayed hypersensitivity
and cellular immunity while humoral antibody formation
remains relatively intact
antilymphocyte
| globulin (ALG)
120
An immunosuppressive antibody directed against the CD3 molecule on the surface of human T cells and can be
useful in the treatment of renal transplant rejection
Muromonab-CD3
121
Effective in reducing systemic inflammation and preventing coronary artery aneurysms in Kawasaki Disease
Immune Globulin Intravenous (IGIV)
122
It has also brought about good
clinical responses in systemic lupus erythematosus and refractory
idiopathic thrombocytopenic purpura (like azathioprine)`
Immune Globulin Intravenous (IGIV)
123
administered to the mother
| within 24–72 hours after the birth of an Rh-positive infant
Rh o (D) Immune Globulin Micro-Dose
124
The usual dose of Rh o (D) immune globulin
2 mL intramuscularly,
| containing approximately 300 mcg anti-Rh o (D) IgG
125
for treatment of respiratory syncytial virus, cytomegalovirus,
varicella zoster, human herpesvirus 3, hepatitis B virus,
rabies, tetanus, and digoxin overdose
Hyperimmune Immunoglobulins
126
humanized IgG 1 with a kappa chain that binds
to CD52 found on normal and malignant B and T lymphocytes,
NK cells, monocytes, macrophages, and a small population of
granulocytes
Antitumor MABs:
| Alemtuzumab
127
Approved for the treatment of B-cell chronic lymphocytic leukemia in patients who have
been treated with alkylating agents and have failed fludarabine
therapy
Antitumor MABs:
| Alemtuzumab
128
Precaution when taking alemtuzumab
patients should
be closely monitored for opportunistic infections and hematologic
toxicity because they may become lymphopenic and may also become neutropenic,
anemic, and thrombocytopenic
129
humanized IgG 1 monoclonal antibody that
binds to vascular endothelial growth factor (VEGF) and inhibits
VEGF from binding to its receptor, especially on endothelial cell
Antitumor MAB: Bevacizumab
130
approved for firstline
treatment of patients with metastatic colorectal cancer alone
or in combination with 5-FU-based chemotherapy
Antitumor MAB: Bevacizumab
131
approved for treatment of non-small cell lung cancer, glioblastoma
multiforme that has progressed after prior treatment, and metastatic
kidney cancer when used with interferon-alpha
Antitumor MAB: Bevacizumab
132
2 precautions when takling bevacizumab
Since bevacizumab
is antiangiogenic, it should not be administered until
patients heal from surgery.
Patients taking the drug should be
watched for hemorrhage, gastrointestinal perforations, and wound
healing problems.
133
Off-label use of bevacizumab
Bevacizumab has also been used off label by
intravitreal injection to slow progression of neovascular macular
degeneration
134
human-mouse chimeric monoclonal antibody
| that targets epidermal growth factor receptor (EGFR)
Antitumor MAB: Cetuximab
135
It is indicated for use in patients with EGFR-positive
metastatic colorectal cancer and, along with radiation therapy, in
patients with head and neck cancer.
Antitumor MAB: Cetuximab
136
HAMAs are generated by about 4% of
| patients being treated with?
Antitumor MAB: Cetuximab
137
a human IgG 1 monoclonal antibody directed
| against a different epitope on CD20 than rituximab
Antitumor MAB: Ofatumumab
138
It is approved
for patients with chronic lymphocytic leukemia (CLL) who are
refractory to fludarabine and alemtuzumab.
Antitumor MAB: Ofatumumab
139
Risk associated with use of Antitumor MAB: Ofatumumab
There is a slight risk of hepatitis B virus reactivation
| in patients taking ofatumumab.
140
fully human IgG 2 kappa light chain monoclonal
| antibody.
Antitumor MAB: Panitumumab
141
It is approved for the treatment of EGFR expressing
metastatic colorectal carcinoma with disease progression
on or following fluoropyrimidine-, oxaliplatin-, and irinotecancontaining
chemotherapy regimens.
Antitumor MAB: Panitumumab
142
Advantage of Panitumumab over Cetuximab
distinct advantage over cetuximab is that it is fully human, and therefore does not elicit HAMAs
143
the first FDA-approved
monoclonal antibody produced from transgenic mice expressing
the human immunoglobulin gene loci.
Antitumor MAB: Panitumumab
144
chimeric murine-human monoclonal IgG 1
(human Fc) that binds to the CD20 molecule on normal and
malignant B lymphocytes and
Rituximab
145
approved for the therapy of
patients with relapsed or refractory low-grade or follicular B-cell
non-Hodgkin’s lymphoma and chronic lymphocytic leukemia
Rituximab
146
approved for the treatment of rheumatoid arthritis in
combination with methotrexate in patients for whom anti-
TNF-α therapy has failed
Rituximab
147
a recombinant DNA-derived, humanized
monoclonal antibody that binds to the extracellular domain of the
human epidermal growth factor receptor HER-2/ neu
Trastuzumab
148
approved for the treatment of
| HER-2 /neu -positive tumors in patients with breast cancer
Trastuzumab
149
approved for the treatment of patients with metastatic gastric or gastroesophageal junction adenocarcinoma.
Trastuzumab
150
MABs Used to Deliver Isotopes to Tumors
Arcitumomab
Capromab pendetide
Ibritumomab tiuxetan
Tositumomab
151
a murine Fab fragment from an anticarcinoembryonic
antigen (CEA) antibody labeled with technetium
99m ( 99m Tc)
Arcitumomab
152
```
used for imaging patients with metastatic
colorectal carcinoma (immunoscintigraphy) to determine extent
of disease
```
Arcitumomab
153
murine monoclonal antibody specific
for prostate specific membrane antigen. It is coupled to isotopic
indium ( 111 In)
Capromab pendetide
154
used in immunoscintigraphy for patients
with biopsy-confirmed prostate cancer and post-prostatectomy in
patients with rising prostate specific antibody level to determine
extent of disease
Capromab pendetide
155
an anti-CD20 murine monoclonal
| antibody labeled with isotopic yttrium ( 90 Y) or 111 In
Ibritumomab tiuxetan
156
approved for use in patients
with relapsed or refractory low-grade, follicular, or B-cell non-
Hodgkin’s lymphoma, including patients with rituximab-refractory
follicular disease.
Ibritumomab tiuxetan
157
anti-CD20 monoclonal antibody
and is complexed with iodine 131 ( 131 I) used in
two-step therapy in patients with CD20-positive, follicular non-
Hodgkin’s lymphoma whose disease is refractory to rituximab and
standard chemotherapy.
Tositumomab
158
Tositumomab should not be administered to
| patients with
greater than 25% bone marrow involvement
159
completely human IgG 1 approved for use in
patients with rheumatoid arthritis, juvenile idiopathic arthritis,
psoriatic arthritis, ankylosing spondylitis, Crohn’s disease, and
plaque psoriasis
Adalimumab
160
recombinant humanized Fab fragment
| that binds to TNF-α.
Certolizumab pegol
161
Certolizumab is indicated for
| patients with
Crohn’s disease and rheumatoid arthritis
162
dimeric fusion protein composed of human IgG 1
| constant regions fused to the TNF receptor
Etanercept
163
approved for adult rheumatoid arthritis,
polyarticular juvenile idiopathic arthritis, ankylosing spondylitis
and psoriatic arthritis.
Etanercept
164
human IgG monoclonal antibody that also
binds to soluble and membrane-associated TNF-α indicated for patients
with rheumatoid arthritis, ankylosing spondylitis, and psoriatic
arthritis.
Golimumab
165
MAB Used as Immunosuppressants and
Anti-Inflammatory Agents that has the advantage of increased half-life such that subcutaneous
injections may be self-administered only once per month.
Golimumab
166
currently
approved for use in Crohn’s disease, ulcerative colitis,
rheumatoid arthritis, ankylosing spondylitis, plaque psoriasis, and
psoriatic arthritis
Infliximab
167
recombinant fusion protein composed of the extracellular
domain of cytotoxic T-lymphocyte-associated antigen 4
(CTLA-4) approved for patients with
rheumatoid arthritis and juvenile idiopathic arthritis
Abatacept
168
Patients on abatacept should..
Patients
should not take other anti-TNF drugs or anakinra while taking
abatacept.
patients should
be screened and treated for latent tuberculosis infection
169
leukocyte-function-associated antigen-3 (LFA-3) fused
to a human IgG 1 Fc region (hinge, CH 2 , and CH 3 ) approved
for the treatment of plaque psoriasis. It
Alefacept
170
They are indicated for prophylaxis
of acute organ rejection in renal transplant patients and either
may be used as part of an immunosuppressive regimen that also
includes glucocorticoids and cyclosporine A.
Basiliximab and Daclizumab
171
humanized IgG4 monoclonal antibody that
binds to the α4-subunit of α4β1 and α4β7 integrins expressed on
the surfaces of all leukocytes except neutrophils indicated for patients with multiple sclerosis and Crohn’s disease
who have not tolerated or had inadequate responses to conventional
treatments.
Natalizumab
172
anti-IgE recombinant humanized monoclonal
antibody that is approved for the treatment of allergic asthma in
adult and adolescent patients whose symptoms are refractory to
inhaled corticosteroids
Omalizumab
173
recombinant humanized IgG 1 that binds to soluble
and membrane-associated IL-6 receptors for treatment of patients with rheumatoid arthritis
who are refractory to other anti-TNF-α biologicals.
Tocilizumab
174
human IgG 1 monoclonal antibody that binds to
| the p40 subunit of IL-12 and IL-23 cytokines for patients with moderate to severe plaque psoriasis
Ustekinumab
175
It is indicated as an adjunct to percutaneous
coronary intervention for the prevention of cardiac
ischemic complications
Abciximab
176
indicated for
treatment of postmenopausal women with osteoporosis at high risk
for fracture.
Denosumab
177
approved for patients with
paroxysmal nocturnal hemoglobinuria (PNH) and dramatically
reduces the need for red blood cell transfusions
Eculizumab
178
monoclonal antibody that binds to the fusion
| protein of respiratory syncytial virus
Palivizumab
179
labeled for
intravitreal injection in patients with neovascular age-related macular
degeneration and sudden blurring or vision loss secondary to
macular edema following retinal vein occlusion
Ranibizumab
180
pegylated oligonucleotide that binds extracellular VEGF and is also
given by intravitreous injection to slow macular degeneration
Pegaptanib
