How Do Immunosuppressants Work?

Immunosuppressants are a class of drugs used to treat and prevent certain medical conditions, includingautoimmunediseases (disorders that cause abnormally low activity or overactivity of theimmune system) such aspsoriasis(animmune-mediateddiseasethat causes raised, scaly patches on theskinbecause ofsystemicinflammation),rheumatoid arthritis(aconditioninwhich the body attacks its own joints causingpain, swelling, and loss of function),lupus,leukemia(cancerthat begins in the whitebloodcells), andorgantransplantations. These drugs inhibit or prevent the activity of the immune system. A few drugs belonging to this class are used to prevent therejectionof a transplanted organ, such as theliver,heart, orkidney; these drugs are called antirejection drugs.

The immune system is a complex network of cells, tissues, and organs. Together, they help the body fight infections and diseases. In conditions such as anautoimmune diseaseor organ transplantation, the immune system mistakenly considershealthytissues and cells to be foreign invaders (virus,bacteria, parasites, chemicals, and toxins) and mounts an attack when there is no invader or does not stop an attack after the invader has been killed. These activities result in autoimmune diseases, allergic reactions, and organtransplantrejection.

Immunosuppressants areprescription-only medicines and are administered as a powder to be mixed withsterile waterto be given intravenously (into avein) and as a solution (liquid) in a prefilledsyringeor an autoinjector to be given subcutaneously (under the skin).

Immunosuppressants work in the following ways:

• They suppress or inhibit the immune system’s activity and prevent it from attacking the transplanted organ, as it attacks any foreign cells, which could otherwise lead to severe damage to the organ.
• They stop the immune system from damaging healthy cells and tissues.
• They work by blocking the activity of T-cells (a type ofwhite blood cell) that directly attacks and eliminates foreign molecules from the body.
• These drugs targetintracellularsignaling pathways induced by the activation of T lymphocytes or T-cells.
• They inhibit calcineurin (anenzymethat activates T-cells of the immune system) and thus inhibit the function of T-cells.
• In addition, they reduce the immune system’s ability to attack the body tissues in some cases of autoimmune diseases (a condition in which the immune system mistakenly attacks the healthy cells in the body).

Immunosuppressants are used in conditions such as:

• Aplastic anemia(a condition that damagesstem cellsin thebone marrow)
• Rheumatoidarthritis(a condition in which the body attacks its own joints, causing pain, swelling, and loss of function)
• Psoriatic arthritis(a condition that causesjointpain and swelling and scales on the skin)
• Giant cell arteritis(an inflammation of the lining of the arteries)
• Plaque psoriasis(characterized by raised red patches covered with a whitish buildup of dead skin cells called scales)
• Ankylosing spondylitis(a condition in which the body attacks the joints of thespineand other areas causing pain and joint damage)
• Chronicrefractorythrombocytopenicpurpura(a blood disorder characterized by a decrease in the bloodplatelet count这可能导致容易或过度的瘀伤和提单eeding)
• Acute lymphoblastic leukemia(a type of cancer of the blood andbonemarrow)
• Lupusnephritis(inflammation of the kidney that is caused bysystemic lupus erythematosus)
• Crohn’s disease (a chronic, or long-term, condition that causes inflammation of the digestive tract)
• Ulcerative colitis(aninflammatory bowel diseasethat affects yourlarge intestine, causing irritation, inflammation, and ulcers in thecolon)
• Multiple sclerosis(a disease in which the nerves do not function properly characterized by weakness, numbness, loss ofmusclecoordination, and problems with vision, speech, andbladder控制)
• Idiopathic pulmonary fibrosis(a chronic,progressivelung disease)
• Spondyloarthritis (a group of inflammatory diseases that cause arthritis)
• Diabetes mellitustype-1 (a condition in which the immune system destroysinsulin-making cells in thepancreas)
• Juvenileidiopathicarthritis (a type ofchildhoodarthritis that affects five or more joints during the first six months of the condition, causing pain, swelling, and loss of function in children two years of age or older)
• Myelodysplastic syndrome(a condition that can occur when the blood-forming cells in the bone marrow becomeabnormal)
• Graftversushostdisease (a life-threateningcomplicationthat can occur after certainstem cellor bone marrow transplants)
• Acuterenalgraft rejection (when the immune system identifies a grafted organ as foreign and attacks it)
• Lupus (a chronic autoimmune condition that can cause inflammation throughout the body)
• Solid organ transplant rejection (attack on the transplanted organ by the immune system of the person receiving the organ)
• Systemic lupus erythematosus (a chronic autoimmune disease that can cause severefatigueand joint pain)
• Lymphangioleiomyomatosis(a rare lung disease that tends toaffectwomen of childbearing age)
• Porphyria cutanea tarda(a rare blood disorder characterized by painful, blistering skin lesions that develop on sun-exposed skin)
• Bronchiolitisobliterans (a type of obstructive lung disease of the small airways)
• Meningeal leukemia (cancer cells spread from the original [primary]tumorto themeninges[thin layers oftissuethat cover and protect thebrainandspinal cord])
• Non-Hodgkinlymphoma(a type of cancer that begins in yourlymphatic system, which is part of the body'sgerm-fighting immune system)
• Squamous cell carcinomaof the head andneck
• Breast cancer
• Osteosarcoma(also called osteogenicsarcomais the most common type of cancer that starts in the bones)
• Gestational trophoblasticneoplasia(a group of rare tumors that develop during the early stages ofpregnancy)
• Prophylaxisand treatment in organ transplantation:
  • Kidney
  • 心
  • Lungs
  • Liver
  • Pancreas
  • Bone marrow

Common side effects include:

• Abdominal pain
• Asthenia(physical weakness or lack of energy)
• Diarrhea
• Dyspnea(shortness of breath)
• Fever
• Headache
• Malaise(a feeling of weakness, overall discomfort, and illness)
• Nausea
• Vomiting
• Muscle cramps
• Back/joint pain
• Cold symptoms such as stuffy head/nose
• Drowsiness
• Pain/tenderness at the injection site
• Other rare side effects include:
• Leukopenia(reduced number of white blood cells)
• Peripheraledema(swelling of lower legs or hands)
• Tachycardia(a fastheart rate—more than 100 beats per minute)
• Thrombocytopenia(low bloodplateletcount)
• Dizziness(feeling faint, weak, or unsteady)
• Increasedsweating
• Hyperuricemia(high blooduric acidlevels)
• Alopecia(a condition that causes hair to fall out in small patches)
• Trouble sleeping
• Urinary tractinfection
• Hives(itchy, raised welts that are found on the skin)
• 低血压(low blood pressure)
• 快速and shallowbreathing
• Chest pain/heaviness
• Swelling of the ankles,feet, and hands
• Signs of kidney problems
• Change in the amount ofurine
• Pink/bloody/frothy urine

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

Genericand brand names of immunosuppressants include:

• Abatacept
• Antithymocyte globulinequine
• Antithymocyte globulin rabbit
• Arava
• Astagraf XL
• ATGequine
• ATG rabbit
• Atgam
• Avsola
• Azasan
• Azathioprine
• Basiliximab
• Belatacept
• CellCept
• Certolizumab pegol
• Cimzia
• Cyclosporine
• Enbrel
• EnvarsusXR
• Erelzi
• Etanercept
• Etanercept-szzs
• Etanercept-ykro
• Eticovo
• Gengraf
• Hecoria
• Hydroxychloroquine sulfate
• 硫唑嘌呤
• Inflectra
• Infliximab
• Infliximab-abda
• Infliximab-axxq
• Infliximab-dyyb
• Infliximab-qbtx
• Ixifi
• Leflunomide
• Methotrexate
• MMF
• Muromonab CD3
• Mycophenolate
• Myfortic
• Neoral
• Nulojix
• Orencia
• Orencia ClickJect
• OrthocloneOKT3
• Otrexup
• Plaquenil
• Prograf
• Rapamune
• Rasuvo
• RediTrex
• Remicade
• Renflexis
• Sandimmune
• Simulect
• Sirolimus
• Sirolimus intravitreal
• Tacrolimus
• Thymoglobulin
• Trexall
• Xatmep