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  • Disease Modifying Anti-Rheumatic Drugs
    20 Drugs classified under this therapeutic system


    All the Therapeutic System Drugs

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    Abitrexate
    Salomon, Levin & Elstein Ltd
    RX
    partial basket chart
    Abitrexate

    Folic Acid Analog. Methotrexate 25 mg/ml.
    VIAL (sol. for inj.): 25 mg/ ml X 2 ml, 4 ml,
    8 ml, 20 ml, 40 ml. Dose must be ajust.
    individ. for each pt. accord. to med.
    cond. See lit.
    Antineopl. Chemother.
    Tmt. of gestational choriocarcinoma,
    chorioadenoma destruens and
    hydatidiform mole. Palliation of ALL. Tmt.
    and proph. of menin. leukemia.
    Greatest effect has been observed in
    palliation of acute lymphoblast.(stemcell)
    leukemias in child. In comb. with
    other anticancer agents, may be used for
    the induc. of remis.,but is most common.
    used in the mainten. of induced remis.
    May be used alone, or in comb. with other
    antineoplastic drugs, in the manag. of
    breast canc., epidermoid cancers of the
    head and neck, lung cancer (partic.
    squamous cell ,small cell types), bladder
    cancer and osteogenic cancer. Tmt. of the
    advan.stages (III and IV, Peter’s Staging
    system) of lymphosarcoma, partic. in
    child., and in advanced cases of mycosis
    fungoides.
    Psoriasis. Indic. only in the sympt. control
    of sev. recalcitrant, disabling psoriasis
    which is not adeq. responsive to other
    forms of therapy, and only when the diag.
    has been established, as by biopsy and/or
    after dermat. consult. RA:Tmt. of selec.
    adul.with sev. RA, only when the diag. has
    been well established accord. to rheumat.
    standards, with inadeq. response to other
    forms of antirheum. ther., includ. full dose
    NSAIDs and usually a trial of at least one
    or more dis.-modif. antirheum. drugs.
    C/I: Pregnancy, lact., pts. in poor state of
    nutrition, sev. ren. impair. (crCL <20 ml/
    min), sev. liver impair., bone marrow
    hypoplasia, leucopenia,
    thrombocytopenia, anemia, alcohol
    abuse, hypersens. and lung toxic.due to
    methotrexate, serious, acute or chronic
    infect. such as tuberculosis and HIV,
    ulcers of the oral cavity and known
    active GI ulcer dis. Concur. vaccin. with
    live vaccines.

    Actemra
    Roche
    RX
    partial basket chart
    Actemra

    Interleukin-6 Receptor Inhibitor. Tocilizumab 20 mg/ml, 162 mg / 0.9 ml.
    VIALS: 1, 4 x 80 mg/4 ml; 200mg/10 ml;
    400 mg/20 ml.
    RA : 8mg/kg bdy wt. I.V. 1 x every 4
    weeks.
    Pts. bdy wt. > 100 kg, dose exceed. 800
    mg/infus. not recommend. See lit. SJIA:
    <30 kg bdywt: 12 mg/kg bdywt, every
    2 wks; ≥30 kg bdywt: 8 mg/kg bdywt,
    every 2 wks.
    Reduce signs/sympts. in adult pts with
    mod-severe active rheum. arthrit. when
    inad. response to one/more DMARDS or
    TNF antags., or in pts unable to use
    DMARDs. Can be used alone/in comb. with
    methotrexate/other DMARDs. Reduce rate
    progress. joint damage as measured by
    X-ray, improve physic. funct. when in
    combinat. methotrexate. Tmt. active
    system. juv. idiopath. arthrit. in pts. > 2 yrs.
    C/I: Hypersens., active severe infects.

    Actemra 162 mg S.C.
    Roche
    RX
    partial basket chart
    Actemra 162 mg S.C.

    Interleukin-6 Receptor Inhibitor. Tocilizumab 162 mg / 0.9 ml.
    PRE- FILLED SYRINGE.: 4 x 162 mg/0.9 ml
    Inj. S.C. 162 mg once a week.
    In comb. with MTX, for the tmt. of moder.-
    severe active RA in adult pt. who have
    either responded inadequate. to, or who
    were intoler. to, prev. therapy with one or
    more DMARDs or TNF antagonists. In
    these pts., Tocilizumab can be given as
    monother. in case of intolerance to MTX or
    where continued tmt. with MTX is
    inappropriate.
    C/I: Hypersens., active severe infects.

    Cosentyx 150 mg
    Novartis
    RX
    partial basket chart
    Cosentyx 150 mg

    Interleukin Inhibitor. Secukinumab 150 mg.
    VIAL(pwdr. for sol. for inj.): 1×6ml.
    PRE FILL. PEN/SYR (sol. for inj.): 1, 2×1ml Plaque psorias.: 300 mg by SC inj. with init. dosing at Weeks 0, 1, 2, 3 and 4, follow. by mnthly. mainten. dosing. Each 300 mg dose is given as two SC inj. of 150 mg. Psoriat. arthrit.: For pts. with concom. moder.-sev. plaque psorias. or who are anti-TNFα inadeq. responders (IR): 300 mg by SC inj. with init. dosing at Weeks 0, 1, 2, 3 and 4, follow. by mnthly. mainten. dosing. Each 300 mg dose is given as two SC inj. of 150 mg.
    For other pts.: dose is 150 mg by SC inj. with init. dosing at Weeks 0, 1, 2, 3 and 4, follow. by monthly mainten. dosing. Ankylos. spondylit.: 150 mg by SC inj. with init. dosing at Weeks 0, 1, 2, 3 and 4, follow. by mnthly. mainten. dosing.
    For all of the above indications, usually achieved within 16 wks. of tmt. Consider. should be given to discont. tmt. in pts. who have shown no response by 16 wks. of tmt. Some pts. with an init. partial response may subseq. improve with continued tmt. beyond 16 wks.
    Plaque psorias.: Tmt. of moder.- sev. plaque psorias. in adult. who are candidates for system. ther.
    Psoriat. arthrit.: Alone or in comb. with methotrexate (MTX): tmt. of active psoriat. arthrit. in adult pts. when the response to previous dis.-modif. anti-rheumatic drug (DMARD) ther. has been inadeq.
    Ankylosing spondylitis: Tmt. of active ankylos. spondylitis in adult. who have responded inadeq. to convent. ther.
    C/I: Severe hypersens. Clinical. important, active infec. (e.g. active tuberculosis).

    Enbrel
    Pfizer
    RX
    partial basket chart
    Enbrel

    TNF Blocking Agent. Etanercept 25, 50 mg.
    (pwdr. for inj.): 25 mg.
    PRE-FILL. SYR. (soln for inj.): 1 x 25 mg;
    1 x 50 mg.
    PRE-FILL. PEN (soln for inj.): 1 x 50 mg.
    Dosage must be ajust. individ.
    RA: Tmt. of active RA in adult. when the
    response to DMARDs include.
    methotrexate (unless contraindic. ) has
    been inadeq. Can be used in comb. with
    methotrexate in pts. who do not respond
    adeq. to methotrexate alone. Reduc.
    signs&sympt. and inhibit. the progress. of
    structur. damage in pts. with moder. –
    sev. act. RA.
    Alone or in comb. with methotrexate, has
    been shown to reduce the rate of
    progress. of joint damage as measure. by
    X-ray and to improve. physic. funct.
    Polyarticul. juven. idiopathic arthrit.:
    Tmt. of active polyarticul. juven.
    idiopathic arthrit. in child. & adolesc. ≥2
    yrs. who have had an inadeq. respon. to,
    or who have proved intoler. of,
    methotrexate. The drug has not been
    studi. in child. < 2 yrs.
    Psor. arthrit.: Tmt. of act. & progress. psor.
    arthrit. in adults when the response to
    prev. DMARDs ther. has been inadeq.
    The has been shown to improve. physic.
    func. in pts. with psoriat. arthrit., and to
    reduce the rate of progress. of peripher.
    joint damage as measured by X ray in pts.
    with polyarticul. symmetric. subtypes of
    the dis.
    Ankylos. spondyl.: Tmt. of adult. with sev.
    act. ankylos. spondyl. who have had an
    inadeq. response to convent. ther.
    Plaque psorias.: Tmt. of adults pts. (18 yrs.
    or older) with moderate to severe plaque
    psor. who are candidates for system. ther.
    or photother.
    Ped. plaque psor. Tmt. of chron. sev.
    plaque psor. in child. &adolesc. from the
    age of 6 yrs. who are inadeq. control. by,
    or are intoler. to, other system. ther. or
    photother.
    Juven. idiopat. arthrit. tmt. of polyarthrit.
    (rheumat. factor posit. or neg.) and
    extended oligoarthritis in child. &
    adolesc. ≥2 yrs who have had an inadeq. response to, or who have proved intoler.
    of, methotrexate.
    Tmt. of psor. arthrit. in adolesc. ≥12 yrs.
    who have had an inadeq. response to, or
    who have proved intol. of, methotrexate.
    Tmt. of enthesitis-related arthrit. in
    adolesc. ≥ 12 yrs. who have had an
    inadeq. respon. to, or who have proved
    intoler. of, convent. ther.
    Axial spondyloarthritis Ankylos.
    spondylitis: Tmt. of adults with sev. active
    ankylosing spondylitis who have had an
    inadeq. response to convent. ther.
    Non-radiograph. axial spondyloarthritis:
    Tmt. of adult. with sev. non-radiograph.
    axial spondyloarthritis with object. signs
    of inflamm. as indic. by elev. CRP and MRI
    evidence, who have had an inadeq.
    response to NSAIDs.
    C/I: Hypersens., sepsis or risk of sepsis,
    Pts. with active infec. , includ. chron. or
    localised infec.

    Humira 20, 40, 80 mg
    AbbVie
    RX
    partial basket chart
    Humira 20, 40, 80 mg

    TNF Blocking Agent. Adalimumab 20 mg / 0.2 ml, 40 mg / 0.4 ml, 80 mg / 0.8 ml.
    PRE-FILLED SYRINGE: 2 (20 mg/0.2 mL, 40mg/0.4ml, 80 mg/0.8 mL).
    PRE-FILLED PEN: 2. (40mg /0.4ml, 80 mg/0.8 mL).
    VIAL (with adaptor): 2. S.C. Dosage must be adjust. individ. accord. to pt. med. cond.
    RA: In comb. with methotrexate: The tmt. of moder.- sev., active RA in adult pts.
    when the response to dis.-modif. anti-rheumatic drugs include. methotrexate has been inadequate.
    The tmt. of severe, active and progres. RA in adults not prev. treated with methotrexate. Can be given as monother. in case of intoler. to methotrexate or when continued tmt. with methotrexate is inapprop.
    This drug has been shown to reduce the rate of progres. of joint damage as measured by X-ray and to improve physic. funct., when given in comb. with methotrexate.
    Juvenile idiopat. arthritis Polyarticular juvenile idiopat. arthritis: In comb. with methotrexate- tmt. of active polyarticular juvenile idiopat. arthritis, in pts. from the age of 2 yrs. who have had an inadequate response to one or more DMARDs. Adalimumab can be given as monother. in case of intoler. to methotrexate or when continued tmt. with methotrexate is inapprop. (for the efficacy in monother.). Adalimumab has not been studied in pts. aged less than 2 yrs.
    Axial spondyloarthritis, Ankylosing spondylitis (AS): Tmt. of adults with sev. act.  ankylos. spondylitis who have had an inadequate response to convent. ther.
    Axial spondyloarthritis without radiographic evidence of AS: Tmt. of adults with severe axial spondyloarthritis without radiograp. evidence of AS, but with object. signs of inflame. by radiolog. and/or lab.tests includ. MRI and serum CRP levels, who have had an inadequate response to, or are intoler. to, non-steroidal anti-inflam. drugs.
    Psoriatic arthritis: Tmt. of active and progres. psoriat. arthritis in adult. when the response to previous dis.-modif. anti-rheum. drug ther. has been inadequate. Adalimumab has been shown to reduce the rate of progres. of periph. joint damage as measured by X-ray in pts. with polyarticular symmetr. subtypes of the dis. and to improve physic. funct.
    Psoriasis: Tmt. of moder.- sev. chron. plaque psoriasis in adult pts. who are candidates for systemic ther.
    Ped. plaque psoriasis: Tmt. of sev. chron. plaque psoriasis in child. and adolesc. from 4 yrs. of age who have had an inadequate response to or are inappropr. candidates for topical ther. and phototherapies. Hidradenitis suppurativa (HS): Tmt. of active moder.- sev. HS (acne inversa) in adult, adolesc. from 12 yrs. of age with an inadequate response to convent. syst. HS ther.
    Crohn’s dis.: Indic. for reduc. signs and sympt. and induc. and maintain. clin. remiss. in adult pts. with moder. - sev. active Crohn’s dis. who have had an inadequate response to conven. ther. The drug is indic. for reduc. signs and sympt. and induc. clin. remiss. in these pts. if they have also lost response to or are intoler. to infliximab.
    Ped.Crohn's dis.: Tmt. of moder. – sev. active Crohn's dis. in ped. pts. (from 6 yrs. of age) who have had an inadequate response to convent. ther. include. prim. nutrition ther. and corticosteroid, and/or an immunomodulator, or who are intoler. or have contraindic. for such ther.
    Ulcer. colit.: Tmt. of moder.- sev. active ulcer. colit. in adult pts. who have had an inadequate response to conven. ther.  include. corticoster. and 6-mercaptopurine or azathioprine, or who are intoler. to or have med. contraind. for such therap.
    Enthesitis-related arthritis: Tmt. of active enthesitis-related arthritis in pts., 6 yrs. of age and older, who have had an inadequate response to, or who are intoler. of conven.  ther.
    Uveitis: Tmt. of non-infec. intermediate, posterior and panuveitis in adult pts. who have had an inadequate response to corticosteroid., in pts. in need of corticosteroid sparing, or in whom corticosteroid tmt. is inappropriate.
    Intestinal Behcet's dis.: Tmt. of intestinal Behcet’s dis. in pts. who have had an inadequate response to convent. ther.
    C/I: Hypersens. Active tuberc., other severe  infec. such as sepsis, and opportun. infec. Moder. - severe HF(NYHA class III/IV).


    Other therapeutic systems under Musculo-Skeletal Disorders

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