Table 1 Update on biologic therapy in autoimmune diseases
| Drug (trade name) | Mechanism of action | Indications |
|---|---|---|
| Tocilizumab (Actemra) |
Recombinant monoclonal IgG1 anti-human interleukin 6-receptor antibody [1] | RA after treatment failure with anti-TNF,1 SJIA1[5–7] |
| Rituximab (Rituxan) | Chimeric human monoclonal antibody against the CD20 protein [12] | RA,1 WG, MPA. Off-label use: ITP, refractory pemphigus vulgaris [13–23] |
| Ofatumumab (Arzerra) | Fully human monoclonal antibody directed against membrane proximal epitope on the CD20 molecule [25] | RA,1[24, 25] |
| Belimumab (Benlysta) | Human monoclonal immunoglobulin IgG1 gamma, which binds to and inhibits the soluble form of the BLyS protein [27, 28] | SLE1[26, 27] |
| Epratuzumab (Lymphocide) | IgG1 monoclonal antibody directed against the CD22molecule [29, 30] | SLE, Sjögren’s syndrome [28–30] |
| Abatacept (Orencia) | CTLA-4 IgG1 binding to CD80/86 on antigen-presenting cells inhibiting the co-stimulation of CD28 on the T cells [32] | RA,1 JIA,1 SLE – discoid, serositis and arthritis manifestations [31–35] |
| Golimumab (Simponi) | IgG1 monoclonal antibody, acting on TNF-α, both soluble and membrane-bound [37] | RA,1 PsA,1 AS1[36–40] |
| Certolizumab (Cimzia) | Pegylated humanized antibody Fab′ fragment of the TNF-α monoclonal antibody [42] | RA1[41, 42] |
| Sifalimumab | An anti-IFN-α monoclonal antibody [44] | Phase III trial [43, 44] |
| Intravenous immunoglobulin | Pool of immunoglobulins from healthy individuals. Many mechanisms involved [48, 49] | SLE, systemic sclerosis, vasculitis [49, 50] |
| Anakinra (Kineret), canakinumab (Ilaris), rilonocept (Arcalyst) | All three are interleukin-1 blockers | RA, CAPS [45–47] |