ABSTRACT
In this chapter, we will present an overview of biological agents used in the management autoimmune and in–ammatory diseases. The Food and Drug Administration (FDA) considers a biologic to be any therapeutic serum, toxin, antitoxin, vaccine, virus, blood, blood component or derivative, allergenic product or analogous product, or derivatives applicable to the prevention, treatment, or
Introduction .................................................................................................................................... 147 Anticytokine Therapy .................................................................................................................... 148 TNF-α, A Unique Target Molecule for the Treatment of In–ammatory Diseases ......................... 149 IL-1 Inhibitors ................................................................................................................................ 152 IL-6 Inhibitor ................................................................................................................................. 152 Other IL Antagonists ...................................................................................................................... 153 T-Cell-Targeted Therapies in the Treatment of Systemic and Cutaneous
Autoimmune Diseases ..................................................................................................... 153 Targeting the Effector Memory T Cells ................................................................................ 154 K+ Channels in the Immune System ..................................................................................... 155
B-Cell-Targeted Therapies in the Treatment of Systemic and Cutaneous Autoimmune Diseases ........................................................................................................ 155 B-Cell-Depleting Agents ...................................................................................................... 156
Angiogenesis Factor ....................................................................................................................... 156 Drugs that Inhibit Leukocyte Adhesion ......................................................................................... 156 New Generations of Biologics ....................................................................................................... 157
Golimumab and Certolizumab .............................................................................................. 157 Therapeutic Ef—cacy Noticed in Clinical Trials ............................................................................. 157
Therapeutic Ef—cacy of Golimumab (Simponi) ................................................................... 157 Certolizumab Pegol (CIMZIA) ............................................................................................. 158
Conclusions .................................................................................................................................... 160 References ...................................................................................................................................... 160
cure of injuries or disease of man. Biologics are designed to “target” speci—c components of the immune system. The goal is to weaken or immobilize those features of the immune system that are triggering autoimmune diseases without the adverse side effects that can come from broadly weakening the immune system [1, 2]. As the new drugs are capable of targeting disease-causing proteins in a more speci—c fashion while also carrying lower risks of adverse side effects, they have considerable advantages over traditional treatments. Biologics are having a major impact on the treatment of these diseases for which there has been signi—cant unmet need for decades. Most of these agents are expensive, as is the laboratory monitoring for side effects that may be required. Cost-effectiveness may be a consideration in choosing to use a biological agent and in picking among the available agents.
