Binds to soluble TNF-a and prevent its interaction with TNF receptor
Given subcutaneously; t1/2 = 10-20 days
Adalimumab
A recombinant, humanized antibody Fab fragment conjugated to a polyethylene glycol (PEG) with specificity to TNF-a
Neutralizes membrane-bound and soluble TNF-a
Given subcutaneously; t1/2 = 14 days
Certolizumab
A recombinant fusion protein consisting of 2 soluble TNF p75 receptor moieties linked to the Fc portion of the human IgG1
Binds to TNF-a and also inhibits lymphotoxin-a
Given subcutaneously; t1/2 = 4.5 days
Etanercept
A human monoclonal antibody with a high affinity for soluble and membrane-bound TNF-a
Given subcutaneously; t1/2 = 14 days
Golimumab
Infliximab
A chimeric (25% mouse; 75% human) IgG1 monoclonal antibody with high affinity for soluble and possibly membrane-bound TNF-a
Given via iv infusion; t1/2 = 9-12 days
Side Effects of TNF inhibitors
Infections
Possibly risk of lymphoma
Injection/infusion reactions
-Umab suffix
Human
-omab suffix
Mouse
-ximab suffix
Chimera
-zumab suffix
humanized
-cept suffix
Fusion protein
A recombinant form of the endogenous IL-1 receptor antagonist (IL-1ra)
Given subcutaneously, t1/2 = 4-6 hours
Anakinra
A recombinant human anti-IL-1b monoclonal antibody that binds to IL-1b and prevents it from binding to IL-1 receptor
Given subcutaneously, t1/2 = 26 days
Canakinumab
A dimeric fusion protein consisting of the
ligand-binding domains of the human IL-1 receptor 1 domain (IL-1RI) and IL-1 receptor accessory protein (IL-1RAcP) fused to the Fc portion of human IgG1.
Given subcutaneously
Rilonacept
Adverse effects of IL-1 inhibitors
Infections
Injection site reactions
Humanized antibody that binds specifically to both soluble and membrane-bound IL-6 receptors (sIL-6R and mIL-6R), and inhibits
IL-6-mediated signaling through these receptors
t1/2: 11-23 days
Indications:
(1) given via iv or sc for rheumatoid arthritis; (2) given via iv for juvenile idiopathic arthritis (polyarticular or systemic)