title: Complications and adverse reactions in the use of newer biologic agents.
abstract: New developments in genetic engineering and biotechnology have allowed the creation of bioengineered molecules that target specific steps in the pathogenesis of several immune-mediated disorders, including Crohn's disease, rheumatoid arthritis, psoriasis and psoriatic arthritis, ankylosing spondylitis, pemphigus, and B-cell lymphoma. These drugs work by eliminating pathogenic T cells (alefacept), blocking T-cell activation and/or inhibiting the trafficking of T cells (efalizumab), changing the immune profile from Th1 to Th2, blocking cytokines (eg, tumor necrosis factor alpha antagonists including etanercept, infliximab and adalimumab, or interleukin-1-receptor antagonists [anakinra]), or eliminating pathogenic B cells (rituximab). This article reviews the complications and adverse reactions associated with these medications.
authors.affiliation: Division of Dermatology, University of Louisville, Louisville, KY 40202, USA. jefca@aol.com
authors.forename: Jeffrey P
authors.initials: JP
authors.lastname: Callen
mesh_terms: D000068879:Adalimumab; D000077944:Alefacept; D000911:Antibodies, Monoclonal / Q000009:adverse effects; D061067:Antibodies, Monoclonal, Humanized; D058846:Antibodies, Monoclonal, Murine-Derived; D018791:CD4 Lymphocyte Count; D000075202:Contraindications; D003879:Dermatologic Agents / Q000009:adverse effects*; D004347:Drug Interactions; D000068800:Etanercept; D006801:Humans; D007074:Immunoglobulin G / Q000009:adverse effects; D007155:Immunologic Factors / Q000009:adverse effects*; D000069285:Infliximab; D053590:Interleukin 1 Receptor Antagonist Protein / Q000009:adverse effects; D018124:Receptors, Tumor Necrosis Factor; D011993:Recombinant Fusion Proteins / Q000009:adverse effects; D000069283:Rituximab; D012871:Skin Diseases / Q000188:drug therapy* / Q000276:immunology; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D058846:Antibodies, Monoclonal, Murine-Derived; D003879:Dermatologic Agents; D007074:Immunoglobulin G; D007155:Immunologic Factors; D053590:Interleukin 1 Receptor Antagonist Protein; D018124:Receptors, Tumor Necrosis Factor; D011993:Recombinant Fusion Proteins; D014409:Tumor Necrosis Factor-alpha; D000069283:Rituximab; D000069285:Infliximab; D000077944:Alefacept; D000068879:Adalimumab; D000068800:Etanercept; C472181:efalizumab