Which of the subq TNF inhibitors are latex-free?
Cimzia and the citrate-free version of Humira
Which of the TNF inhibitors contain latex?
Enbrel, and Simponi pen and PFS
Which of the interleukin inhibitors contain latex?
Cosentyx, Stelara
Which meds for inflammation have a REMS, and what is it for?
- Siliq for suicidal ideation
- Tysabri TOUCH program for PML risk
- Gattex to increase awareness of neoplastic growth, colon polyp growth, GI obstruction, and billiary/pancreatic disorders
Which meds used for inflammation have a contraindication, and what is it?
- Siliq is CI in Chrohn’s Disease
- Krystexxa is CI in G6PD deficiency
- Otrexup/Rosuvo is pregnancy category X
Which meds have a loading dose for RA?
- Cimzia
- Simponi IV
- Remicade
- Orencia (optional LD)
- Rituxan
Which inflammations meds are LDD?
- Kineret
- Arcalyst
- Ilaris
Which meds have to be administered by a healthcare provider?
- Cimzia vials medical benefit
- Ilaris
- Stelara vial may be administered at MDO under medical benefit, or at home under pharmacy benefit
- Ilumya can only be administered at MDO, and billed under either medical or pharmacy benefit
Which meds have recommended infusion times?
- Simponi, Orencia, Entyvio over 30 minutes
- Tysabri over 1 hour
- Remicade and Krystexxa over ≥2 hours
Which medications have dose adjustments, and what are they?
- Remicade mod-severe CHF (NYHA Class III-IV) ,≤ 5mg/kg dose
- Kineret, CrCl <30mL/min QOD dosing
- Actemra and Kevzara, dose reduction or d/c for abnormal liver function test, neutropenia or thrombocytopenia
- Xeljanz, Rinvoq and Olumiant, dose reduction or d/c for renal or hepatic impairment, anemia, lymphopenia or neutropenia
- Xeljanz dose reduction or d/c w/strong CYP3A4 or CYP2C19 inhibitors
- Xeljanz/Rinvoq avoid use with CYP3A4 inducers
- Olumian, avoid use w/OAT3 inhibitors
- Otezla for CrCl<30mL/min, final dose is 30mg QAM (3, 2, then 1qd)
- Gattex, CrCl <60mL/min, decrease dose by 50% qd (to 0.025mg/kg daily)
Which medications should be discontinued upon a timed lack-of response?
- Siliq, d/c if no response in 12-16 weeks
- Entyvio, d/c if no benefit by week 14
- Tysabri, d/c if no benefit by week 12
- Krystexxa, consider d/c if UA levels increase to >6 mg/dL
Which infusions require pre-medications?
- Remicade: antihistamine, APAP and/or steroids
- Rituxan: antistamime, APAP, methylprednisolone 100mg IV 30 minutes prior to infusion
- Krystexxa: antinhistamine and steroids
Which inflammation medication may exacerbate COPD, and what are its indications?
Orencia
Which medications may lead to intestinal perforations, and what are their indications?
What are the indications and doses for Cimzia?
What are the doses and indications for Enbrel?
What are the indications and doses for Humira?
What are the indications and dosing schedules for Simponi?
What are the indications and doses for Remicade?
Which meds are IL23 inhibitors, and what disease do they all treat?
- Tremfya, Skyrizi and Ilumya all treat plaque psoriasis
- Tremfya also treats psoratic arthritis
- Ilumya is stable at room temp for > 30 days
