[Recombinant proteins or monoclonal antibodies: comparative properties and interest in rheumatoid arthritis].
Therapeutics options for inflammatory diseases, such as rheumatoid arthritis (RA), have increased tremendously in the past decade with the introduction of biologic therapies, such as monoclonal antibodies or recombinant fusion proteins. These have proven to be highly successful in treating inflammatory or autoimmune diseases, by blocking certain key molecules involved in the pathogenesis of the illness, cytokines (TNF) or immune coactivators (CTLA-4). Thus in rheumatoid arthritis, TNF can be neutralized both by monoclonal antibodies (adalimumab, infliximab) or recombinant inhibitors such as etanercept or CTLA-4 Ig abatacept. All have been marketed and proven to be highly effective in the treatment of RA, and we will discuss parameters which are taken into account to select monoclonal antibody or recombinant inhibitors. These include drug-related (target affinity, pharmacokinetics, mechanisms of action, etc.) and patient - (efficacy and side effects) or disease-related characteristics. Their impact on current clinical practice and future trends are discussed.
Sibilia
Jean
J
Centre national de référence << Maladies auto-immunes systémiques rares >>, service de rhumatologie, CHU de Strasbourg, Hôpital de Hautepierre, 1, avenue Molière, BP 83049, 67098 Strasbourg Cedex, France. jean.sibilia@wanadoo.fr
D000069594:Abatacept; D000068879:Adalimumab; D000893:Anti-Inflammatory Agents / Q000737:chemistry / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000737:chemistry / Q000276:immunology / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D000068582:Certolizumab Pegol; D000068800:Etanercept; D006801:Humans; D018796:Immunoconjugates / Q000737:chemistry / Q000627:therapeutic use; D007140:Immunoglobulin Fab Fragments / Q000737:chemistry / Q000627:therapeutic use; D007074:Immunoglobulin G / Q000737:chemistry / Q000627:therapeutic use; D007155:Immunologic Factors / Q000737:chemistry / Q000627:therapeutic use; D056747:Immunomodulation; D007249:Inflammation / Q000188:drug therapy*; D000069285:Infliximab; D011092:Polyethylene Glycols / Q000737:chemistry / Q000627:therapeutic use; D011487:Protein Conformation; D018124:Receptors, Tumor Necrosis Factor / Q000737:chemistry / Q000627:therapeutic use; D011993:Recombinant Fusion Proteins / Q000737:chemistry / Q000627:therapeutic use*; D013329:Structure-Activity Relationship; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors* / Q000276:immunology
D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D018796:Immunoconjugates; D007140:Immunoglobulin Fab Fragments; D007074:Immunoglobulin G; D007155:Immunologic Factors; D018124:Receptors, Tumor Necrosis Factor; D011993:Recombinant Fusion Proteins; D014409:Tumor Necrosis Factor-alpha; D011092:Polyethylene Glycols; D000069594:Abatacept; C529000:golimumab; D000069285:Infliximab; D000068879:Adalimumab; D000068800:Etanercept; D000068582:Certolizumab Pegol