immunosuppressants

see also:

• pharmacology main index
• progressive multifocal leukoencephalopathy (PML)
• immunodeficiency
• the immunocompromised patient in the ED

• azathioprine
• corticosteroids
• cyclosporin
• methotrexate
• cytotoxic agents
• immunosuppressive monoclonal antibodies (mAbs)
• topical immune modifiers:
  • imiquimod - Rx of solar keratoses, BCC, etc
• selective interleukin inhibitors:
  • canakinumab - IL-1beta inhibitor for Rx of cryopyrin associated periodic syndromes
  • tocilizumab - IL-6 inhibitor for Rx of rheumatoid arthritis
  • ustekinumab - IL-12 and IL-23 monoclonal Ab for Rx of severe psoriasis
• selective tumour necrosis factor (TNF) inhibitors:
  • certolizumab - TNFalpha inhibitor for Rx of rheumatoid arthritis
  • etanercept - TNF inhibitor for Rx of rheumatoid arthritis
  • adalimumab - TNFalpha inhibitor for Rx of rheumatoid arthritis
  • infliximab - TNFalpha inhibitor for Rx of rheumatoid arthritis
• interferons:
  • interferon alpha-2b: Rx of hairy cell leukaemia, Kaposi's sarcoma, chronic hepatitis B/C, CML, multiple myeloma, non-Hodgkin's lymphoma, melanoma, etc
  • interferon beta-1a: Rx of relapsing multiple sclerosis (MS)
  • interferon beta-1b: Rx of multiple sclerosis (MS)
  • interferon gamma-1b: reduces infections in chronic granulomatous disease
• other transplant rejection prevention agents:
  • mycophenolate mofetil - renal allograft rejection in children
  • everolimus - mTOR inhibitor also used to Rx AD polycystic kidney disease (ADPKD)
  • sirolimus
  • tacrolimus - macrolide lactone immunosuppressant used as adjunctive Rx
  • antithymocyte globulin - to reduce peripheral T cell function in renal transplant recipients
  • basiliximab - renal allografts
• other immunosuppressant agents used in Rx of rheumatoid arthritis:
  • leflunomide - Rx of rheumatoid arthritis and psoriatic arthritis
  • abatacept - CD80+CD86 and CD28 interaction costimulator modulator.
  • TNF antagonists
  • anti-CD20 monoclonal antibodies (see below)
• other immunosuppressant agents used in Rx of multiple sclerosis (MS)
  • glatiramer
  • cladribine - purine nucleoside analogue
  • natalizumab - humanised IgG-4 monoclonal Ab to alpha-4 integrin
• immunosuppressant agents used to Rx hereditary angioedema (HAE):
  • icatibant - bradykinin 2 receptor antagonist
  • human C1 esterase inhibitor
• immune modulators for Rx of asthma:
  • omalizumab - anti-IgE agent which appears to reduce seasonal peaks in exacerbations in inner city children with asthma ¹⁾
• lenalidomide - for Rx of multiple myeloma and transfusion dependent anaemia
• thalidomide - for Rx of multiple myeloma
• temsirolimus - Rx of advanced renal cell Ca, and relapsed, refractory mantle cell lymphoma