Target | Agent | Structure | Mechanism of action | Approval for RA | Approval for PsoA | ||
---|---|---|---|---|---|---|---|
FDA | Health Canada | FDA | Health Canada | ||||
TNF | Etanercept | Fusion protein Fc IgG1-TNFR2 | Decoy receptor | Nov 1998 | Dec 2000 | Jan 2002 | Mar 2004 |
Infliximab | Chimeric mAb to TNF | Antagonist | Nov 1999 | Sep 2001 | May 2005 | Jun 2006 | |
Adalimumab | Humanized mAb to TNF | Jan 2003 | Sep 2004 | Oct 2005 | Jun 2006 | ||
Golimumab | Human mAb to TNF | Apr 2009 | Apr 2009 | Oct 2017 | Apr 2009 | ||
Certolizumab pegol | Pegylated Fab’ fragment of humanized mAb to TNF | May 2009 | Sep 2009 | Sep 2013 | Jan 2014 | ||
IL-1 | Anakinra | Recombinant human IL-1 receptor | Receptor antagonist | Nov 2001 | Jun 2002 | – | – |
Canakinumab | Human mAb to IL-1β | Antagonist | – | – | – | – | |
Rilonacept | Fusion protein Fc IgG1 linked to ligand-binding domains of IL-1R1 and IL-1RAcP | ||||||
CTLA-4 | Abatacept | Fusion protein Fc IgG1-CTLA-4 | Binds CD80 and CD86 on APCs; prevents co-stimulation of T cells | Dec 2005 | Jun 2006 | Jul 2017 | Mar 2018 |
CD20 | Rituximab | Chimeric mAb to CD20 | Binds CD20 on B cells; triggers cell death | Feb 2006 | Jun 2006 | – | – |
Ocrelizumab | Humanized mAb to CD20 | – | – | – | – | ||
Ofatunumab | Human mAb to CD20 | – | – | – | – | ||
Obinutuzumab | Humanized mAb to CD20 with a glycoengineered Fc | – | – | – | – | ||
IL-6 | Tocilizumab | Humanized mAb to IL-6 receptor | Receptor antagonist | Jan 2010 | May 2010 | – | – |
Sarilumab | Human mAb to IL-6 receptor | May 2017 | Feb 2017 | – | – | ||
IL-12, IL-23 | Ustekinumab | Human mAb to IL-12 and IL-23 p40 subunit | Antagonist | – | – | Sep 2013 | Jan 2014 |
IL-17 | Secukinumab | Human mAb to IL-17A | Antagonist | – | – | Jan 2016 | Apr 2016 |
Ixekizumab | Human mAb to IL-17A | – | – | Dec 2017 | Jun 2018 | ||
Brodalumab | Human mAb to IL-17 receptor A | Receptor antagonist | – | – | – | – | |
Janus kinase 1–3 | Tofacitinib | Small molecule | Intracellular inhibitor; blocks activity of cytokines (IL-2, -4, -6, -7, -9, -10, -12, -15, -21, -23, IFN-α, -β, -γ) | Nov 2012 | Apr 2014 | Dec 2017 | Oct 2018 |