Table 1

Update on biologic therapy in autoimmune diseases
Drug (trade name) Mechanism of action Indications
Tocilizumab (Actemra)

Recombinant monoclonal IgG1 anti-human interleukin 6-receptor antibody


RA after treatment failure with anti-TNF,1 SJIA1[5-7]
Rituximab (Rituxan) Chimeric human monoclonal antibody against the CD20 protein [12] RA,1 WG, MPA. Off-label use: ITP, refractory pemphigus vulgaris [13-23]
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 [28-30]
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 [31-35]
Golimumab (Simponi) IgG1 monoclonal antibody, acting on TNF-α, both soluble and membrane-bound [37] RA,1 PsA,1 AS1[36-40]
Certolizumab (Cimzia) Pegylated humanized antibody Fabfragment 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 [45-47]

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.

Rosman et al.

Rosman et al. BMC Medicine 2013 11:88   doi:10.1186/1741-7015-11-88

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