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


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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.

    Benlysta 120 mg, 400 mg
    GSK
    RX
    partial basket chart
    Benlysta 120 mg, 400 mg

    Monoclonal Antibody. Belimumab 120 mg, 400 mg.
    VIAL (pwdr. for concentrate for sol. for infus.): 1×120mg.
    VIAL (pwdr. for concentrate for sol. for infus.): 1×400mg.
    Benlysta 120,400 mg: Premed. includ. an antihistamine, with/without an antipyretic, may be admin. before the  infus. The recomm. dose is 10 mg/kg on Days 0, 14 and 28, and at 4-wk. interv. thereafter. The patient’s condition should be evaluated continuous. Discont. of tmt. should be consid. if there is no improve. in dis. control after 6 mnths. of tmt. See lit.
    Indic. as add-on ther. in adult pts. with active, autoantibody-posit. system. lupus erythematosus (SLE) with a high degree of dis. activity (e.g., positive anti-dsDNA and low complement) despite standard ther.
    C/I: Hypersens.

    Benlysta 200 mg
    GSK
    RX
    partial basket chart
    Benlysta 200 mg

    Monoclonal Antibody. Belimumab 200 mg.
    PRE-FILL. PEN (sol. for S.C. inj.): 1, 4×200mg/ml.
    PRE-FILL.SYR. (sol. for S.C. inj.): 1, 4×200mg/ml.
    Benlysta 200mg/ml: 200 mg once wkly., admin. S.C. dosing is not based on weight.
    The pt’s. condition should be evaluat. continuous. Discont. of tmt. should be consid. if there is no improv. in dis.  control after 6 mnths. of tmt.
    If a dose is missed, it should be admin. as soon as possible. Thereafter, pts. can resume dosing on their usual day of admin., or start a new wkly.
    Transit. from IV to S.C. admin.: If a pt. is being transitioned from IV admin. to S.C. admin., the 1st S.C. inj. should be admin. 1-4 wks. after the last IV dose. See lit.
    Indic. as add-on ther. in adult pts. with active, autoantibody-posit. system. lupus erythematosus (SLE) with a high degree of dis. activity (e.g., positive anti-dsDNA and low complement) despite standard ther.
    C/I: Hypersens.

    Cimzia
    Neopharm
    RX
    partial basket chart
    Cimzia

    TNF-A Inhibitors. Certolizumab Pegol 200 mg/ml.
    PRE-FILL. SYR. (sol. for S.C. inj.): 2, 6×1ml. The recomm. init. dose adult pts. is 400 mg (given as 2 s.c. inj. of 200 mg each) at wks. 0, 2 and 4. For RA, MTX should be cont. during tmt. with Certolizumab pegol where approp.
    Mainten. dose: RA: After the init. dose, the recomm. mainten. dose of Certolizumab pegol for adult pts. with RA is 200 mg every 2 wks. MTX should be cont. during tmt. with Certolizumab pegol where appropr.
    Axial spondyloarthritis: After the init. dose, the recomm. mainten. dose of Certolizumab pegol for adult pts. with Axial spondyloarthrit. is 200 mg every 2 wks. or 400 mg every 4 wks.
    For the above indicat., available data suggest that clinical response is usually achieved within 12 wks. of tmt. Continued ther. should be carefully reconsid. in pts. who show no evidence of therapeutic benefit within the first 12 wks. of tmt.
    Crohn’s Dis.: After the init. dose, in pts. who obtain a clinical response, the recomm. mainten. dose is 400 mg every 4 wks.
    Missed dose: Pts. who miss a dose should be advised to inject the next dose of Certolizumab pegol as soon as they remember and then cont. inject. subseq. doses as instructed.
    RA: In comb. with methotrexate (MTX), is indic. for: The tmt. of moder. to sev., active RA in adult pts. when the response to dis.-modifying antirheum. drugs (DMARDs) includ. methotrexate, has been inadequate.
    Can be given as monother. in case of intoler. to MTX or when cont. tmt. with MTX is inappropr.
    Certolizumab pegol has been shown to reduce the rate of progres. of joint damage as measured by X-ray and to improve physic. func., when given in comb. with MTX.
    Axial spondyloarthritis: Tmt. of adult pts. with sev. active axial spondyloarthritis, compris.: Ankylosing spondyl. (AS): Adults with sev. active AS who have had an inadeq. response to, or are intoler. to NSAIDs.
    Axial spondyloarthritis without radiograp. evidence of AS: Adult. with sev. active AS without radiograph. evidence of AS but with object. signs of inflamm. by elevated CRP and/or MRI, who have had an inadeq. response to, or are intoler. to NSAIDs.
    Crohn’s Dis.: Indic. for reduc. signs and sympt. of Crohn’s dis. and maintain. clinic. response in adult pts. with moderat. to sev. active dis. who have had an inadequ. response to convent. ther.
    C/I: Hypersens. Active tuberculosis or other sev. infec. such as sepsis or opportunist. infect. Moder-to sev. heart fail. (NYHA classes III/IV).


    Other therapeutic systems under Musculo-Skeletal Disorders

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