How Do Immunomodulators (DMARDs) Work?

即时通讯munomodulators (DMARDs) belong to a class of medications known as disease-modifying anti-rheumatic drugs (DMARDs), which modify and slow down or halt the course of disease in manyautoimmuneand other inflammatory diseases and cancers.

即时通讯munomodulators include synthetic compounds that are toxic to cancer cells, biologicmonoclonalantibodies against specific antigens, and small molecule drugs that are capable of penetrating cells and altering their functions. Immunomodulators work in diverse ways to modify immune cell functions to control inflammation and tumor growth.

一些免疫调制剂的DMARDs suppress theimmune systemand prevent abnormal cell growth include the following:

• Inhibit the activation of T-lymphocytes, immune cells that attack specific antigens they perceive as foreign to the body.
• Block the activity of pro-inflammatory proteins released by immune cells, including:
  • Interleukin-1 alpha and beta mediate inflammatory responses such as fever.
  • Interleukin-6 has many functions such as activation of T-cells, induction ofimmunoglobulin(antibody) secretion, stimulation ofimmune responsefrom the liver, and stimulation of blood cell proliferation and differentiation.
• Inhibit the division of cells by interfering with DNA and RNA synthesis.
• Preventmalignantcell growth by cross-linking DNA in tumor cells.
• Prevent T-cell proliferation and activation by inhibiting calcineurin, a key signaling enzyme.
• Prevent cell division and proliferation by inhibiting enzymesessentialfor nucleotide (DNA and RNA building blocks) synthesis.
• Inhibit enzymes known as Janus kinases (JAK) which transmit signals from the cell membrane within the cell, stimulating an immune response and blood cell formation.

即时通讯munomodulators (DMARDs) may be administered through the following routes:

• 口语:
  • 平板电脑
  • Capsules
  • Solutions
• Injections:
  • Subcutaneous (SC) injection into the tissue under the skin
  • Intramuscular(IM) injection into the muscle
  • Intravenous (IV) injections or infusions into the vein
  • Intrathecal (IT) injections into thecerebrospinal fluidin the spinal canal

即时通讯munomodulators (DMARDs) are used in the treatment of conditions that include the following:

FDA-approved:

• Rheumatoid arthritis, an autoimmune inflammatory disease that affects joints
• Psoriatic arthritis, a form ofarthritisthat develops in people withpsoriasis, a skin condition
• Juvenileidiopathicarthritis, a form of arthritis that develops in children
• Juvenile idiopathic arthritis/vasculitis
• Systemic juvenile idiopathic arthritis
• Polyarticular juvenile idiopathic arthritis
• Cryopyrin-associated periodic syndromes (CAPS), a group of rare inherited diseases due to defect in the gene that codes for the protein cryopyrin, which includes:
  • Neonatal-onset multisystem inflammatory disease (NOMID) also known as a chronic infantileneurological,cutaneousand articular syndrome (CINCA)
• Deficiency of interleukin-1 receptorantagonist, a rare genetic condition that causes systemic inflammation
• Giant cell arteritis (inflammation of arteries)
• Kidney transplantation, to prevent transplant rejection
• Solid-organ transplant including liver, heart, and kidney, to prevent transplant rejection
• Nephrotic syndrome, a kidney disorder that causes excessive excretion of protein in the urine
• Systemic lupus erythematosus, anautoimmune disease
• Psoriasis
• Malignant diseases (cancers)
• Non-Hodgkin’slymphoma
• Breast cancer
• Acute lymphoblasticleukemia
• Meningeal leukemia
• Osteosarcoma
• Squamous cellcarcinomaof head and neck
• Gestational trophoblasticneoplasia, a rare form of tumor that develops during pregnancy
• Interstitiallung disease, a group of diseases that scarlungs
• Cytokine release syndrome, a systemicinflammatory responsetriggered by infections or certain drugs
• Ulcerative colitis

Off-label:

• Crohn’s disease, an inflammatory bowel disease
• Chronicrefractorythrombocytopenicpurpura, an autoimmune disorder that suppresses platelet production and destroys them
• Kidney transplantation, to prevent transplant rejection in children
• Solid-organ transplant including liver, heart, and kidney, to prevent transplant rejection in children
• Lupusnephritis, kidney inflammation caused by lupus
• Juvenile idiopathic arthritis/vasculitis in adults
• Systemicsclerosis, an autoimmune disease that hardens and tightens skin andconnective tissue
• Ectopic pregnancy

Orphan:

• Diabetes mellitustype I
• Graft versus host disease, acomplicationafter transplant in which the donor cells attack the host cells
• Still’s a disease, a rare form of arthritis
• Bronchiolitis obliterans, an inflammation of the small airways (bronchioles) in the lungs, caused by aviral infection
• Amyotrophiclateralsclerosis (ALS), aneuromusculardisease
• 创伤性脑损伤
• Myasthenia gravis, a neuromuscular disease
• Ectopicpregnancy
• Proliferativevitreoretinopathy, a rare condition that causes scar tissue formation in theretinaand can lead to vision loss

Emergency use authorization (EUA):

• COVID-19

Some of the most common side effects of immunomodulators (DMARDs) may include the following:

• Injection site reaction
• Arachnoiditis (inflammation of the arachnoid membrane around thespinal cord) with intrathecal administration
• Subacutetoxicity with intrathecal administration (paralysisof extremities,cranialnervepalsy,seizure, or coma)
• Demyelinatingencephalopathy(inflammation of brain and spinalcordthat damages myelin, the protective sheath on nerve fibers) with cranialirradiationor other systemicchemotherapy
• Headache
• Nasopharyngitis (inflammation of nose and throat)
• Pharyngitis(throat inflammation)
• Ulcerative stomatitis (inflammation in the mouth)
• Glossitis(inflammation of the tongue)
• Gingivitis(inflammation of gums)
• Mucositis (inflammation of themucousmembranes of the digestive tract)
• Nausea
• Vomiting
• Abdominal discomfort
• Diarrhea
• Dyspepsia(indigestion)
• 厌食症(loss of appetite)
• Constipation
• Intestinal perforation
• Reddening of skin
• Infections
• Upper respiratory infection
• Arthralgia(joint pain)
• 腿抽筋
• Pyrexia (fever)
• Leukopenia(low count ofleukocytes, type of immune cells)
• Neutropenia(low count of neutrophils, type of immune cells)
• Thrombocytopenia(lowplatelet countin the blood)
• Tremor
• Paresthesia(skin prickling sensation)
• Nephrotoxicity (toxicity to the kidney)
• Nephropathy(kidney disease)
• Renal failure
• Hyperuricemia(excessuric acidin the blood)
• Azotemia(elevation ofblood urea nitrogen[BUN] and serum creatinine levels)
• Hypertension(high blood pressure)
• Hirsutism(abnormal male pattern hair growth in women)
• Hypertrichosis (abnormally excessive hair growth in men/women)
• Female reproductive disorders
• Gumhyperplasia(overgrowth)
• Increase in triglyceride levels

Information contained herein is not intended to cover all possible side effects, precautions, warnings, drug interactions, allergic reactions, or adverse effects. Check with your doctor or pharmacist to make sure these drugs do not cause any harm when you take them along with other medicines. Never stop taking your medication and never change your dose or frequency without consulting your doctor.

Genericand brand names of immunomodulators (DMARDs) include:

• abatacept
• Actemra
• anakinra
• Azasan
• azathioprine
• cyclophosphamide
• cyclosporine
• Cytoxan
• Gengraf
• 即时通讯uran
• Kineret
• methotrexate
• Neoral
• Orencia
• Orencia ClickJect
• Otrexup
• Rasuvo
• RediTrex
• Sandimmune
• tocilizumab
• tofacitinib
• Trexall
• Xatmep
• Xeljanz
• Xeljanz XR