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Table 1 Update on biologic therapy in autoimmune diseases

From: Biologic therapy for autoimmune diseases: an update

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[57]

Rituximab (Rituxan)

Chimeric human monoclonal antibody against the CD20 protein [12]

RA,1 WG, MPA. Off-label use: ITP, refractory pemphigus vulgaris [1323]

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 [2830]

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 [3135]

Golimumab (Simponi)

IgG1 monoclonal antibody, acting on TNF-α, both soluble and membrane-bound [37]

RA,1 PsA,1 AS1[3640]

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 [4547]

  1. 1Approved by the US Food and Drugs Administration. Abbreviations: AS, ankylosing spondylitis; BLyS, B-lymphocyte stimulator; CAPS, cryopyrin-associated periodic syndrome; CTLA, cytotoxic T lymphocyte-associated; JIA, juvenile idiopathic arthritis; MPA, microscopic polyangiitis; PsA, psoriatic arthritis; RA, rheumatoid arthritis; SLE, systemic lupus erythematosus; TNF, tumor necrosis factor; Wegener’s granulomatosis.