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Infliximab
5%
54/1066
Rituximab
59%
627/1066
Etanercept
22%
233/1066
Golimumab
7%
73/1066
Adalimumab
72/1066
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Rituximab is a chimeric monoclonal antibody against the protein CD20, which is primarily found on the surface of immune system B cells. Rituximab is used in combination with methotrexate to treat RA that has not responded to one or more types of treatment, including anti-tumor necrosis factor (TNF) blockers. In rheumatoid arthritis, and other chronic inflammatory conditions, cytokines produced by activated T-cells/macrophages contribute to the pro-inflammatory state. TNF-alpha is thought to be one of the major cytokines involved in rheumatoid arthritis pathology. As a result, many biologic agents used to treat RA are directed towards blocking TNF-alpha or its receptors. These drugs are able to reduce inflammation and stop disease progression. Elliot et al. evaluated the safety and efficacy of infliximab in 20 patients with active RA in an open phase I/II trial lasting 8 weeks. They found that treatment with anti-TNFa was safe, well tolerated and resulted in significant clinical and laboratory improvements. Illustration A depicts five commonly used anti-TNF alpha biologic agents for the treatment of rheumatoid arhtirits with their usual dosing regimens. Incorrect Answers: Answer 1, 3-5: All of these biologic agents target TNF-alpha
2.7
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