Golimumab

Golimumab Brand Names- Simponi | SIMPONI ARIA

What is Golimumab

Golimumab is a TNF-alpha blocker (TNF blocker). The drug is available in both intravenous and subcutaneous formulations.

Golimumab subcutaneous injections are given once monthly for maintenance treatment.

The intravenous infusion is given every 8 weeks for maintenance therapy following therapy induction.

As with other TNF blockers, golimumab is efficacious for a variety of inflammatory conditions. Golimumab is indicated for the treatment of adults with moderately to severely active rheumatoid arthritis (RA), psoriatic arthritis (PsA), or ankylosing spondylitis (AS).

In adults with rheumatoid arthritis (RA) or psoriatic arthritis (PsA) the drug improves clinical signs and symptoms, inhibits the radiographic progression of structural joint damage, and improves physical function; in adults with ankylosing spondylitis (AS), the drug improves clinical signs and symptoms of active disease.

For adult RA the drug is used with methotrexate, for PsA or AS golimumab may be used as monotherapy or used with other disease-modifying antirheumatic drugs (DMARDs).

The ideal combination of therapy for individual patients with inflammatory arthritis conditions is determined by treat to target strategies and severity of disease.

For PsA, TNF-blockers are considered a first-line treatment, even in treatment-naive patients.

Golimumab is also indicated in adults with moderate to severe ulcerative colitis; the drug induces and maintains symptomatic improvement and clinical remission in responders, improving endoscopic appearance of the mucosa during induction.

As with other TNF-alpha blockers, golimumab carries a boxed warning that highlights risk for serious infections and potential malignancy

Indications

  1. ankylosing spondylitis
  2. psoriatic arthritis
  3. rheumatoid arthritis
  4. ulcerative colitis

For the treatment of moderately to severely active rheumatoid arthritis (RA) in combination with methotrexate

Side Effects

  1. agranulocytosis
  2. anaphylactoid reactions
  3. antibody formation
  4. aplastic anemia
  5. bullous rash
  6. constipation
  7. dizziness
  8. dyspnea
  9. elevated hepatic enzymes
  10. erythema
  11. exfoliative dermatitis
  12. fever
  13. Guillain-Barre syndrome
  14. heart failure
  15. hepatic failure
  16. hepatitis
  17. hypertension
  18. infection
  19. influenza
  20. injection site reaction
  21. interstitial lung disease
  22. leukopenia
  23. lichen planus-like eruption
  24. lupus-like symptoms
  25. nausea
  26. neutropenia
  27. new primary malignancy
  28. pancytopenia
  29. paresthesias
  30. peripheral neuropathy
  31. pruritus
  32. psoriasis
  33. rash
  34. serious hypersensitivity reactions or anaphylaxis
  35. sinusitis
  36. thrombocytopenia
  37. urticaria
  38. vasculitis
  39. weakness

Monitoring Parameters

  • CBC with differential
  • hepatitis B serology
  • skin cancer screening exam
  • tuberculin skin test

Contraindications

  • agranulocytosis
  • aplastic anemia
  • autoimmune disease
  • bone marrow suppression
  • breast-feeding
  • children
  • cholangitis
  • chronic obstructive pulmonary disease (COPD)
  • corticosteroid therapy
  • diabetes mellitus
  • fungal infection
  • geriatric
  • Guillain-Barre syndrome
  • heart failure
  • hepatitis
  • hepatitis B exacerbation
  • immunosuppression
  • infants
  • infection
  • inflammatory bowel disease
  • influenza
  • latex hypersensitivity
  • leukemia
  • leukopenia
  • lymphoma
  • multiple sclerosis
  • mycobacterial infection
  • neonates
  • neutropenia
  • new primary malignancy
  • optic neuritis
  • pregnancy
  • sepsis
  • skin cancer
  • thrombocytopenia
  • tuberculosis
  • ulcerative colitis
  • vaccination
  • viral infection

Interactions

  • Abatacept
  • Adalimumab
  • Anakinra
  • Antithymocyte Globulin
  • Azathioprine
  • Bacillus Calmette-Guerin Vaccine, BCG
  • Baricitinib
  • Basiliximab
  • Belimumab
  • Canakinumab
  • Certolizumab pegol
  • Cyclophosphamide
  • Cyclosporine
  • Dexamethasone
  • Efalizumab
  • Etanercept
  • Infliximab
  • Influenza Virus Vaccine
  • Intranasal Influenza Vaccine
  • Live Vaccines
  • Measles Virus; Mumps Virus; Rubella Virus; Varicella Virus Vaccine, Live
  • Measles/Mumps/Rubella Vaccines, MMR
  • Methotrexate
  • Methylprednisolone
  • Muromonab-CD3
  • Natalizumab
  • Prednisolone
  • Prednisone
  • Rilonacept
  • Rituximab
  • Rituximab; Hyaluronidase
  • Rotavirus Vaccine
  • Rubella Virus Vaccine Live
  • Sarilumab
  • Smallpox and Monkeypox Vaccine, Live, Nonreplicating
  • Smallpox Vaccine, Vaccinia Vaccine
  • Theophylline, Aminophylline
  • Tocilizumab
  • Tofacitinib
  • Typhoid Vaccine
  • Upadacitinib
  • Varicella-Zoster Virus Vaccine, Live
  • Vedolizumab
  • Warfarin
  • Yellow Fever Vaccine, Live
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