Which medications in the drug class Immunosuppressants are used in the treatment of Takayasu Arteritis?

Updated: Nov 14, 2018
  • Author: Jefferson R Roberts, MD; Chief Editor: Herbert S Diamond, MD  more...
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Answer

Immunosuppressants

These agents inhibit key factors that mediate immune reactions. [50]

Azathioprine (Imuran, Azasan)

Azathioprine may be added to treatment if there has been no response to steroid therapy or if the patient has been on steroid treatment for a long period of time. Azathioprine antagonizes purine metabolism and inhibits the synthesis of DNA, ribonucleic acid (RNA), and proteins. It may decrease the proliferation of immune cells, which results in lower autoimmune activity.

Mycophenolate (CellCept, Myfortic)

Mycophenolate inhibits inosine monophosphate dehydrogenase (IMPDH) and suppresses de novo purine synthesis by lymphocytes, thereby inhibiting their proliferation. Mycophenolate inhibits antibody production.

Two formulations are available and are not interchangeable. The original formulation, mycophenolate mofetil (CellCept), is a prodrug that, once hydrolyzed in vivo, releases the active moiety mycophenolic acid. A newer formulation, mycophenolic acid (Myfortic), is an enteric-coated product that delivers the active moiety.

Tacrolimus (Prograf)

Tacrolimus suppresses humoral (T-lymphocyte) immunity.

Infliximab (Remicade)

Infliximab may be added to treatment if steroids and other immunosuppressant drugs are ineffective in achieving or maintaining remission. Infliximab is a chimeric IgG1k monoclonal antibody that neutralizes cytokine TNF-α and inhibits its binding to the TNF-α receptor. It reduces the infiltration of inflammatory cells and TNF-α production in inflamed areas.

Tocilizumab (Actemra)

Tocilizumab is an IL-6 receptor inhibitor. IL-6 inhibition results in a decreased C-reactive protein level to within the normal range, decreased values in other pharmacodynamic parameters (eg, rheumatoid factor, erythrocyte sedimentation rate, amyloid A), and an increased hemoglobin value.

Rituximab (Rituxan)

Rituximab is a chimeric murine/human monoclonal antibody directed against the CD20 antigen found on the surface of B-lymphocytes.


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