Biologics – SeekHealthZ

Uses of xanthine oxidase inhibitors

Seekhealthz Editorial — Mon, 12 Oct 2020 07:19:22 +0000

In addition to gout when else might xanthine oxidase inhibitors be used? • Hyperuricosuria (24-hour urine uric acid >1100 mg) due to risk of uric acid nephrolithiasis. • Prophylaxis against tumor lysis syndrome. • Hypoxanthine phosphoribosyltransferase deficiency (Lesch–Nyhan syndrome). • Hyperuricemia due to myeloproliferative disorders. • Hyperuricemia with nephrolithiasis of any type.

Can biologic agents be given during pregnancy and breastfeeding

Seekhealthz Editorial — Mon, 12 Oct 2020 06:39:12 +0000

Can biologic agents be given during pregnancy and breastfeeding? TNF inhibitors and ustekinumab are FDA Pregnancy Classification B (old classification) medications. They can be used if clinically necessary for the mother’s health. It should be noted that only 4% of the maternal blood level of ETN is detected in the fetal circulation. Immunoglobulins do not …

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Can live vaccines be given to patients on biologics – Research Facts

Seekhealthz Editorial — Mon, 12 Oct 2020 06:38:38 +0000

Can live vaccines be given to patients on biologics? No. Commonly used live vaccines include measles (MMR, Proquad), varicella (Varivax), oral rotavirus, Zostavax, and Flumist. Yellow fever, BCG, oral typhoid, and adenovirus (military personnel) are live vaccines given only to high-risk groups, whereas small pox and oral polio are rarely given today. Live vaccines are …

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What factors can make a patient less likely to respond to bDMARD therapy

Seekhealthz Editorial — Mon, 12 Oct 2020 06:38:21 +0000

What factors can make a patient less likely to respond to bDMARD therapy? Can two biologic agents be used together? Recent reports suggest that 5% to 10% of patients will fail three or more bDMARDs used to treat their underlying rheumatic disease. These patients are defined as being bDMARD-resistant. The most important factor is to …

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Belimumab

Seekhealthz Editorial — Sat, 10 Oct 2020 17:42:54 +0000

What are the indications, efficacy, and toxicities of belimumab (Benlysta)? • FDA-approved indication: SLE. Does not work in RA. • Available formulation: single-use vial containing 120 mg or 400 mg of lyophilized powder for reconstitution. A 200-mg/mL single-dose prefilled autoinjector or syringe is also available. • IV dosage: loading dose of 10 mg/kg IV at 0, 2, and …

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Indications of Rituxan

Seekhealthz Editorial — Sat, 10 Oct 2020 13:44:58 +0000

What are the indications and toxicities of RTX (Rituxan)? • FDA-approved rheumatologic indications: RA after MTX and anti-TNF failure; ANCA-associated vasculitis (granulomatosis with polyangiitis [GPA], microscopic polyangiitis [MPA]). • Available formulation: single-use vial of 100 mg and 500 mg. • Dosage. RA: 1000-mg IV infusion repeated once 2 weeks later. Some physicians feel 500-mg dose is as effective …

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Can more than one TNF inhibitor be tried

Seekhealthz Editorial — Sat, 10 Oct 2020 11:56:52 +0000

Can more than one TNF inhibitor be tried in a patient? Any guidelines for switching? Most physicians and patients feel that at least a 50% overall clinical response is necessary to justify the cost and risk of using a TNF inhibitor. At least 50% of patients with RA, AS, or PsA may not achieve this …

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B cell targeted therapies

Seekhealthz Editorial — Sat, 10 Oct 2020 11:44:20 +0000

What are B cell targeted therapies? RTX (Rituxan): chimeric mouse–human IgG1κ monoclonal antibody directed against extracellular domain of CD20 antigen on B cells. B cells are eliminated by complement-mediated lysis, antibody-dependent cell-mediated cytotoxicity, or apoptosis. All peripheral B cells are eliminated within days. Patients who fail to deplete their B cells respond less well. Notably, Ig …

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What bDMARDs are available to inhibit IL 17

Seekhealthz Editorial — Sat, 10 Oct 2020 11:43:52 +0000

What bDMARDs are available to inhibit IL 17 in the rheumatic diseases? Secukinumab (Cosentyx) is a human IgG1κ monoclonal antibody which blocks IL-17A. It is FDA-approved to treat psoriasis, PsA, and AS. Not effective for RA. • Available formulations: 150 mg/mL solution in a single-use Sensoready pen or prefilled syringe that is self-administered. There is also a …

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ustekinumab

Seekhealthz Editorial — Sat, 10 Oct 2020 11:43:26 +0000

What is ustekinumab and why is it effective in PsA? Ustekinumab (Stelara) is a human IgG1κ monoclonal antibody that binds to the p40 subunit of both IL-12 and IL-23 preventing their binding to their shared cell surface receptor chain, IL-12β. The inhibition of IL-12 signaling abrogates Th1 response with reduction in TNF-α, IFN-γ, and IL-2 production. …

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