RA - L6 Flashcards Preview

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Flashcards in RA - L6 Deck (19)
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1
Q

Where is TNFa sythesised?

A

activated macrophages

T cells

2
Q

What are the TNFa receptors?

A

TNFR1(p55) & TNFR2(p75)

3
Q

Pro-inflammatory TNF cytokine cascade

A

TNFa
IL-1
IL-6, IL-8, GM-CSF

4
Q

Anti-inflammatory TNF cytokine cascade

A

TNFa
IL-1
IL-10, IL-ra, sTNF-R

5
Q

What are some anti-TNF bDAMRs?

A
infliximab (chimeric)
etanercept
adalimumab (fully human)
certolizumab pegol
golimumab
6
Q

What is the 60-40-20 rule?

A

60% - ACR20
40% - ACR50
20% - ACR70

7
Q

Non-responders to TNFis

A

primary failure
secondary failure
neutralising antibodies (HACA &HAHA)

8
Q

What are some safety issue with TNFis?

A
administration
cytopaenia
infections (URT & soft tissue)
heart failure
demyelinating disease
malignancy
autoimmunity
9
Q

Mavrilimumab

A

fully human monoclonal Ab that inhibits the a subunit of the GM-CSF receptor

10
Q

Tofacitinib

A

novel oral JAK inhibitor
limits T cell & other leukocyte recruitment
first intracellular treatment!
adverse effects

11
Q

What is a chimeric TNFa inhibitor?

A

Infliximab

12
Q

What drug is a fusion protein of two p75 TNFa receptors? (TNFa inhibitor)

A

Etanercept

13
Q

What drug is a fully human monoclonal antibody? (TNFa inhibitor)

A

Adalimumab

14
Q

What drug is a humanized monoclonal antibody that is durable? (TNFa inhibitor)

A

Certolizumab Pegol

15
Q

What drug is human IgG1 kappa monoclonal antibody? (TNFa inhibitor)

A

Golimumab

16
Q

What drug is a IL-1 receptor blockade?

A

Anakinra

17
Q

What drug is a T cell costimulation blocker (CTLA4)?

A

Abatacept

18
Q

What drug is a B cell depletion molecule?

A

Rituximab

19
Q

What drug is a IL-6 receptor blockade?

A

Tocilizumb