The handbook of biological therapy : a guide to the use and safety of biological therapies in rheumatology, dermatology, and gastroenterology

Tumor Necrosis Factor (TNF) blocking therapy has recently been introduced as an important new class of biologic therapy for rheumatoid arthritis, ankylosing spondylitis, Crohn's disease, psoriasis and psoriatic arthritis. This class of drugs, currently comprised of three different agents, is being increasingly used for these around the world. Intensive clinical research is also defining new areas in which these drugs will be used in the future. These new indications for TNF-blocking therapy will increase the number of physicians using this class of drug. This guide provides a comprehensive distillation of the clinical experience with these drugs combined with the diverse available databases to provide practical information about the use of these drugs in daily practice. Much of the literature currently available has come from the clinical trial setting with an academic emphasis. This book is rigorously practical and is the guide that every physician including all rheumatologists, and gastroenterologists and dermatologists who treat patients with this class of drugs, will want to have on hand to answer their questions that arise every day. Contents 10 Foreword 6 Preface 8 TNF – tumour necrosis factor α 12 Mode of action of anti-TNF 13 TNF-blocking drugs in clinical use 14 TNF-blocking drugs not in clinical use 15 Section 1 TNF-blocker safety 16 Increased risk of infection 17 Tuberculosis 18 Opportunistic infections 22 Injection-site reactions 22 Allergic, hypersensitivity reactions, anaphylactic responses 22 Psoriasis 23 Infusion reactions (infliximab) 23 Malignancy and lymphoproliferative conditions 24 Drug-induced lupus-like reactions 27 Anti-drug antibodies (immunogenicity) 27 Congestive heart failure 28 Neurological 29 Hepatobiliary 30 Use in pregnancy 31 Lactation 32 Respiratory 32 Vaccinations 32 Use of TNF-blockers with other medications 33 Haematological 33 Postmarketing safety experience in Crohn’s disease 33 Section 2 Rheumatology 42 Rheumatoid arthritis 42 Other rheumatological conditions 49 TNF-blocking therapy in ankylosing spondylitis and psoriatic arthritis 53 Ankylosing spondylitis 53 Psoriatic arthritis 59 Adalimumab (Humira) 63 Etanercept (Enbrel) 72 Infliximab (Remicade) 83 Certolizumab pegol (Cimzia) 94 Abatacept (Orencia) 96 Anakinra (Kineret) 104 B-cell depletion: Rituximab (Rituxan® [USA], MabThera® [Europe, Asia, South America]) 108 Section 3 Dermatology 113 Psoriasis 113 Approaches to management 114 Assessing disease severity 115 Important differences between psoriasis and rheumatoid arthritis 116 Biological therapy for psoriasis 116 Etanercept (Enbrel) 118 Infliximab (Remicade) 121 Adalimumab (Humira) 125 Efalizumab (Raptiva) 128 Alefacept (Amevive) 133 Section 4 Gastroenterology 137 Biological therapy in inflammatory bowel disease and Crohn’s disease 137 Adalimumab (Humira) 146 Infliximab (Remicade) 150 Natalizumab (Tysabri) 158 Certolizumab pegol (Cimzia) 163 Index 166 A 166 B 166 C 166 D 167 E 167 G 167 H 167 I 167 K 168 L 168 M 168 N 168 O 168 P 168 R 168 S 169 T 169 U 170 V 170 Drugs produced by molecular biological techniques, called the'biologics', differ from the usual chemical medications. Their optimum use, and the detection and managemenet of adverse events, pose a significant challenge to the clinician. Licences for new biologics continue to be granted for the likes of rituximab, abatacept and certocizumals pegol. Intensive research is also defining new areas in which these drugs will be used in the future, increasing the number of practitioners using biologics. As the use of these drugs increases around the world, so the level of information needed by primary care practitioners and specialist prescribers needs to be expanded The Handbook of Biological Therapy provides the practising clinician with a practica guide to the use of Tumour Necrosis Factor Blocking Therapy (TNF-blockers), and important new class of biologic therapy for rheumatoid arthritis, ankylosing spondylitis, Crohn's disease, ulcerative colitis, psoriasis, and psoriatic arthritis. It is a comprehensive distillation of the authors'clinical experience with these drugs, combined with data from diverse databases offering practical advice on their uses, specific indications, supporting clinical trial data and safety issues, with the aim of making the use of these drugs easier for the busy clinician. All of the authors have been involved from the beginnings of the clinical trial programmes with these drugs and continue to use them in daily practice.

tumor Necrosis Factor (tnf) Blocking Therapy Has Recently Been Introduced As An Important New Class Of Biologic Therapy For Rheumatoid Arthritis, Ankylosing Spondylitis, Crohn's Disease, Psoriasis And Psoriatic Arthritis. This Class Of Drugs, Currently Comprised Of Three Different Agents, Is Being Increasingly Used For These Around The World. Intensive Clinical Research Is Also Defining New Areas In Which These Drugs Will Be Used In The Future. These New Indications For Tnf-blocking Therapy Will Increase The Number Of Physicians Using This Class Of Drug.
this Guide Provides A Comprehensive Distillation Of The Clinical Experience With These Drugs Combined With The Diverse Available Databases To Provide Practical Information About The Use Of These Drugs In Daily Practice. Much Of The Literature Currently Available Has Come From The Clinical Trial Setting With An Academic Emphasis. This Book Is Rigorously Practical And Is The Guide That Every Physician Including All Rheumatologists, And Gastroenterologists And Dermatologists Who Treat Patients With This Class Of Drugs, Will Want To Have On Hand To Answer Their Questions That Arise Every Day.

"Drugs produced by molecular biological techniques, called the 'biologics', differ from the usual chemical medications. This book provides the practising clinician with a practical guide to the use of Tumor Necrosis Factor Blocking Therapy (TNF-blockers), a new class of biologic therapy for rheumatoid arthritis, ankylosing spondylitis, Crohn's disease, ulcerative colitis, psoriasis and psoriatic arthritis. It is a distillation of the authors' clinical experience with these drugs, combined with data from diverse databases offering practical advice on their uses, specific indications, supporting clinical trail data and safety issues, with the aim of making the use of these drugs easier for the busy clinician."--BOOK JACKET Drugs produced by molecular biological techniques, called the 'biologics', differ from the usual chemical medications. Their optimum use, and the detection and managemenet of adverse events, pose a significant challenge to the clinician. Licences for new biologics continue to be granted for the likes of rituximab, abatacept and certocizumals pegol. Intensive research is also defining new areas in which these drugs will be used in the future, increasing the number of practitionersusing biologics. As the use of these drugs increases around the world, so the level of information needed by primary