Article Figures & Tables
Tables
Biologic type Drug name Structure Indication for use* Anti-TNFα Infliximab Chimeric anti-TNFα IgG1 Rheumatoid arthritis, ankylosing spondylitis, Crohn disease, ulcerative colitis, plaque psoriasis Adalimumab Recombinant humanized anti-TNFα IgG1 Rheumatoid arthritis, polyarticular JIA, psoriatic arthritis, ankylosing spondylitis, Crohn disease, ulcerative colitis, hidradenitis suppurativa, plaque psoriasis, uveitis Golimumab Humanized anti-TNFα IgG1 Rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, nonradiographic axial spondyloarthritis, ulcerative colitis Certolizumab pegol Recombinant, humanized antibody to the antigen-binding fragment to anti-TNFα Rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, plaque psoriasis Etanercept Human recombinant TNFα receptor/IgG1-Fc fusion protein Ankylosing spondylitis, rheumatoid arthritis, polyarticular JIA, psoriatic arthritis, plaque psoriasis Anticytokine Ustekinumab Anti-IL-12 and IL-23 humanized IgG1 Plaque psoriasis, psoriatic arthritis, Crohn disease, ulcerative colitis Tocilizumab Anti-IL-6 receptor humanized IgG1 Rheumatoid arthritis, polyarticular and systemic JIA, giant cell arteritis Canakinumab Anti-IL-1β human IgG1 CAPS, TRAPS, HIDS, MKD, FMF, systemic JIA Anti-integrin Vedolizumab Humanized anti-α4β7 integrin IgG1 Ulcerative colitis, Crohn disease Natalizumab Anti-integrin α4 subunit humanized IgG4 Multiple sclerosis Anti-B cell Rituximab Anti-CD20 IgG1 Rheumatoid arthritis, non-Hodgkin lymphoma, chronic lymphocytic leukemia, granulomatosis with polyangiitis Belimumab Anti-B-cell activating factor human IgG1 Systemic lupus erythematosus Note: CAPS = cryopyrin-associated periodic syndromes, FMF = familial Mediterranean fever, HIDS = hyperimmunoglobulin D syndrome, Ig = immunoglobulin, IL = interleukin, JIA = juvenile idiopathic arthritis, MKD = mevalonate kinase deficiency, TNF = tumour necrosis factor, TRAPS = tumour necrosis factor receptor associated periodic syndrome.
↵* Off-label use not listed.
- Table 2:
Drug transfer, estimated drug clearance and clinical experience of monoclonal antibody biologics in pregnancy
Biologic Drug transfer to fetus Estimated drug clearance in the infant Level of clinical experience* Reference Infliximab High 3–7 mo ++++ (2), (15), (33), (36), (44) Adalimumab Moderate 3–5 mo ++++ (2), (15), (33), (44) Golimumab Moderate Unknown + (38) Certolizumab pegol Minimal (passive diffusion) NA +++ (2), (15), (41), (42), (45)– (47) Etanercept Low 0–3 mo +++ (39), (40) Ustekinumab Moderate Unknown + (15), (37), (38) Vedolizumab Low-moderate Likely < 3 mo + (15), (38), (43), (44) Natalizumab Low-moderate Unknown + (15), (38), (48), (49) Rituximab Moderate-high Unknown + (50), (51) Belimumab Unknown Unknown + (52) Note: NA = not applicable.
↵* We categorized the amount of clinical experience into 4 levels depending on size and quality of studies: + = least clinical experience (i.e., small case reports and case series only) to ++++ = largest clinical experience (i.e., large prospective cohort studies with > 1000 participants enrolled).