Biologic therapy for autoimmune diseases: an update

Rosman, Ziv; Shoenfeld, Yehuda; Zandman‐Goddard, Gisele

doi:10.1186/1741-7015-11-88

Cited by 202 publications

(169 citation statements)

References 55 publications

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“…The introduction of therapies that work by selectively blocking mechanisms involved in the inflammatory immune response has revolutionized the treatment for numerous autoimmune conditions (1). The US Food and Drug Administration approved the first of the targeted immunomodulators (TIMs) in 1998 (infliximab).…”

Section: Introductionmentioning

confidence: 99%

Comparative Risk of Harm Associated With the Use of Targeted Immunomodulators: A Systematic Review

Desai

Thaler

Mahlknecht

et al. 2016

Arthritis Care & Research

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ObjectiveTo systematically compare the risk of adverse events (AEs) for 13 targeted immunomodulators (TIMs) indicated for ankylosing spondylitis (AS), inflammatory bowel diseases, juvenile idiopathic arthritis, plaque psoriasis, psoriatic arthritis (PsA), or rheumatoid arthritis (RA).MethodsWe searched electronic databases through July 2015 to retrieve randomized controlled trials (RCTs) and observational studies comparing AEs between 2 or more TIMs head‐to‐head. We reported on the following outcomes: number of AEs, discontinuation due to AEs, serious AEs, mortality, serious infections, tuberculosis, herpes zoster, and malignancies. We qualitatively synthesized the literature and conducted random‐effects meta‐analyses if 3 or more studies provided data for an outcome.ResultsTen head‐to‐head RCTs and 51 observational studies were included in this systematic review. A majority of the studies (70%) were conducted in RA patients. Risk of treatment discontinuation due to AEs was higher with infliximab than with adalimumab or etanercept in RA, PsA, and AS. A higher risk for serious infections was noted with infliximab than with abatacept, adalimumab, or etanercept in RA. Risk for treatment discontinuation due to AEs, serious infections, and tuberculosis was lower with etanercept than with adalimumab in RA. Limited evidence suggested no comparative differences in risk for mortality, malignancies, and herpes zoster for adalimumab, etanercept, and infliximab in RA.ConclusionImportant differences were noted in the safety profile of TIMs in RA, generally favoring abatacept, adalimumab, and etanercept over infliximab. Head‐to‐head comparative evidence for other TIMs and non‐RA populations was insufficient to draw conclusions for most of the safety outcomes.

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Section: Introductionmentioning

confidence: 99%

Comparative Risk of Harm Associated With the Use of Targeted Immunomodulators: A Systematic Review

Desai

Thaler

Mahlknecht

et al. 2016

Arthritis Care & Research

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“…Anti-TNF-α agents are approved for the treatment of rheumatoid arthritis, seronegative spondyloarthropathies and inflammatory bowel diseases [7]. Contrasting with its well-proven role in other inflammatory diseases, the relevance in SSc and in profibrotic conditions is still conflicting.…”

Section: Tumour Necrosis Factor αmentioning

confidence: 99%

“…Biological agents have indeed significantly changed the prognosis of different conditions not only in rheumatology [rheumatoid arthritis (RA), seronegative spondyloarthropathies and systemic lupus erythematous (SLE)] but also in neurological, dermatological and gastrointestinal diseases [6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Biological Therapy in Systemic Sclerosis

Caetano¹,

Oliveira²,

Alves³

2017

Systemic Sclerosis

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Systemic sclerosis is the autoimmune connective tissue disease with the highest morbidity and mortality, through the combination of inflammation, vasculopathy and fibrosis leading to severe internal organ involvement. Currently, there are no approved diseasemodifying therapies, and treatment is based on organ-specific treatment and broad immunosuppression, with disappointing long-term results in most cases. Recent research has helped to improve knowledge of the pathogenesis of systemic sclerosis and to optimize treatment based on specific physiopathological targets, and a new era of biological agents in systemic sclerosis has now begun. Promising results are emerging from targeting specific cytokine signalling, especially IL-6, and cellular subpopulations such as B cells, with anti-CD20 therapy, and T-cells, with inhibition of T-cell co-stimulation. Other approaches under evaluation are based on the modulation of profibrotic pathways by anti-TGF-β agents. In this chapter, we discuss the available evidence to support the use of each biological agent in systemic sclerosis based on data from basic and translational research and on results from clinical studies.

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“…The arsenal of biological therapies available to treat chronic inflammatory diseases, especially autoimmune and autoinflammatory disorders as well as cancer, but also cardiovascular and neurological diseases, is quickly expanding as a result of better understanding of molecular mechanisms together with improved production capacity [4,254]. These therapies include (by class): novel anti-TNFα blockers (fully humanized or pegylated), anti-interleukin (IL) agents (to IL-1, IL-6), B-cell-directed therapies (to CD20, CD22), interference with co-activation signaling (CTLA4-Ig), intravenous immunoglobulins (IVIGs), and antibodies to tumor antigens.…”

Section: Historymentioning

confidence: 99%

Applications of immunochemistry in human health: advances in vaccinology and antibody design (IUPAC Technical Report)

Klein

Templeton

Schwenk

2014

Pure and Applied Chemistry

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This report discusses the history and mechanisms of vaccination of humans as well as the engineering of therapeutic antibodies. Deeper understanding of the molecular interactions involved in both acquired and innate immunity is allowing sophistication in design of modified and even synthetic vaccines. Recombinant DNA technologies are facilitating development of DNA-based vaccines, for example, with the recognition that unmethylated CpG sequences in plasmid DNA will target Toll-like receptors on antigen-presenting cells. Formulations of DNA vaccines with increased immunogenicity include engineering into plasmids with "genetic adjuvant" capability, incorporation into polymeric or magnetic nanoparticles, and formulation with cationic polymers and other polymeric and non-polymeric coatings. Newer methods of delivery, such as particle bombardment, DNA tattooing, electroporation, and magnetic delivery, are also improving the effectiveness of DNA vaccines. RNA-based vaccines and reverse vaccinology based on gene sequencing and bioinformatic approaches are also considered. Structural vaccinology is an approach in which the detailed molecular structure of viral epitopes is used to design synthetic antigenic peptides. Virus-like particles are being designed for vaccine deliveries that are based on structures of viral capsid proteins and other synthetic lipopeptide building blocks. A new generation of adjuvants is being developed to further enhance immunogenicity, based on squalene and other oil-water emulsions, saponins, muramyl dipeptide, immunostimulatory oligonucleotides, Toll-like receptor ligands, and lymphotoxins. Finally, current trends in engineering of therapeutic antibodies including improvements of antigen-binding properties, pharmacokinetic and pharmaceutical properties, and reduction of immunogenicity are discussed. Taken together, understanding the chemistry of vaccine design, delivery and immunostimulation, and knowledge of the techniques of antibody design are allowing targeted development for the treatment of chronic disorders characterized by continuing activation of the immune system, such as autoimmune disorders, cancer, or allergies that have long been refractory to conventional approaches.

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Biologic therapy for autoimmune diseases: an update

Cited by 202 publications

References 55 publications

Comparative Risk of Harm Associated With the Use of Targeted Immunomodulators: A Systematic Review

Comparative Risk of Harm Associated With the Use of Targeted Immunomodulators: A Systematic Review

Biological Therapy in Systemic Sclerosis

Applications of immunochemistry in human health: advances in vaccinology and antibody design (IUPAC Technical Report)

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