Part 3: Inflammatory diseases: TK2i,

Deucravacitinib

Sotyktu

PP

indication for sotyktu

rhabdomyolysis

Sotyktu: check for s/sx of _________

tyrosine kinase 2 inhibitor

Sotyktu is a _____ _____ __ _____

t cell inhibitor

Abatacept is a __ ___ _____

abatacept

orencia

125 mg SC weekly (+ / - IV loading dose)

RA and PsA dosing for Orencia

live vaccines

orencia: avoid __ _____ concurrently and w/in 3 months of d/c

Malignancies, anaphylaxis, COPD exacerbation

rare ADEs of Orencia

2

Orencia is approved for use in > __ yo PsA pediatric patients

RA, PsA (adults and peds), JIA

indications for Orencia

apremilast

Otezla

bechets disease, PP (adult and peds), PsA (adult and peds)

Otezla indications

HA, weight loss, diarrhea, N/V, abdominal pain, URI

common side effects for Otezla

50, 30

Otezla: for adults and peds; >__ and CrCl < ___ 30 mL/min: 10 mg QAM x 3 days, 20 mg QAM x 2 days, then 30 mg QAM

depression, suicidal ideation

rare side effects for Otezla

CYP450

Otezla: avoid use with strong _______ inducers

6, 20

Otezla: Approved for PP and PsA use in adults and > __ yo pediatric patients weighing at least _ kg

PDE-4 inhibitor

Otezla is a ___ _____-

PDE inhibitor

Zoryve is a topical ____ _____

roflumilast

Zoryve

AD (adults and peds), PP (adults and peds), SD

indications for Zoryve

HA, site pain, diarrhea, N/V, insomnia, nasopharyngitis

common ADEs for Zoryve

B-lymohocyte Stimulator Protein inhibitor

belimumab is a ______ ______ ______

belimumab

benlysta

SLE (adults and peds) , Lupus nephritis (adults and peds)

indications for Benlysta

severe active

Benlysta: not recommended for use in ____ ___ lupus nephritis, or CNS lupus

PML, suicide ideation

rare side effects for Benlysta

5

Benlysta: approved for use in >__ yo SLE and LN (SC and IV) pediatric patients

integrin receptor antagonist

vedolizumab is a _____ _____ ____

vedolizumab

entyvio

CD, UC

indications for entyvio

CYP450

entyvio: upon initiation or d/c of entyvio in patients treated with ______ substrates, monitor drug concentrations or other therapeutic parameters, and adjust the dosage of the CYP substrate as needed

108mg q 2 weeks

CD and UC dosing for entyvio

fatigue, nausea, increase LFTs, flu, back/limb pain, URI, fever, hypersensitivity

less common ADE for entyvio

selective adhesion-molecule inhibitor

natalizumab is a ____ _______ _____

natalizumab

Tysabri

CD

indication for Tysabri

REMS

Tysabri has a _____ program due to PML risk

taper off steroids

Tysabri: D/C is can not ___ ____ ___ within 6 months

PML

Tysabri has a boxed warning for ____

Anti-CD20 Monoclonal antibody

rituxumab is a _____ ______ ______

rituximab

rituxan

RA, Pemphigous Vulgaris, granulomatosis w/ polyangiitis or microscopic polyangiitis

indications for rituximab

Premedicate

Rituxan: one should ______ with antihistamine, APAP, and methylprednisolone 100 mg IV 30 mins prior to each dose

_____

ritxuan: _____ monitoring during infusion if history of arrhythmias

HBV reactivation, fatal infusion reactions, mucocutaneous reactions, PML

Rituxan has a boxed warning for _______________

urate-oxidase enzyme

pegloticase is a _____ _____

pegloticase

Krystexxa

gout

Krystexxa indication

IV

formulation for Krystexxa

G6PD

Krystexxa is contraindicated in ______ deficiency

anaphylactic infusion reactions, G6PD deficiency

Krystexxa has a boxed warning for ____________

8 mg q 2 weeks w/ MTX

dosing for Krystexxa

anti-IgG monoclonal antibody

Xolair is a ____ _____ ____

omalizumab

Xolair

chronic idiopathic urticaria

indication for Xolair

150 mg or 300 mg q 4 weeks

dosing for Xolair

150 mg

Xolair: doses over ______ should be divided over more than one injection site and separated by > 1 inch

anaphylaxis

Xolair has a boxed warning for _______

Dihydrofolate Reductase inhibitor

methotrexate is a _____ _____ ______

pregnancy category X

MTX is classified as _______ _____ __

folic acid 1 mg

Methotrexate should be used with _____ ____ ____

restrict ethanol use

Methotrexate patients should _____ _____ ____

bone marrow suppression, aplastic anemia, GI toxicity, opportunistic infection, pneumonitis, secondary malignancy, hepatic, renal , skin, lung toxicities

boxed warnings for MTX

PP, RA, pJIA

indications for MTX

GLP-2 analog

teduglutide is a _____ ____

teduglutide

Gattex

SBS

indication for Gattex

refrigerate

Gattex: _______ prior to dispense then 90 days BUD once dispensed (needs to be reconstituted)

REMS

Gattex has a _____ program due to increase in neoplastic growth, colon polyp growth, GI obstruction, and biliary/pancreatic disorders

Colonoscopy

Gattex: a ______ is needed w/in 6 mos prior and 12 mos after starting, then Q5 years

fluid status

Gattex: monitor ______ w/ CHF patients

S1P Receptor Modulator

ozanimod is a ___ ____ ___

S1p receptor modulator

estrasimod is a ___ ____ ____

estrasimod

Velsipty

ozanimod

Zeposia

UC

Zeposia and Velsipty indication

contraindication for S1P receptor modulator

if patient experienced in the last 6 months: MI, unstable angina, stroke/TIA, Decompensated HF requiring hospitalization, OR Class III/IV HF, presence of Mobitz type II 2nd or 3rd degree AV block, sick sinus syndrome, sino-atrial block, unless the patient has a functioning pacemaker

specific C/I for ozanimod

severe untreated sleep apnea, or taking a MAO inhibitor

2 weeks

ozanimod: if a dose is missed during the first __ _____ of treatment, titration has to be reinitiated at 0.23 mg once daily

Interferon Receptor Antagonist Type 1

Anifrolumab is a ______ _____ ____ ____ ___

anifrolumab

Saphnelo

SLE

Saphnelo is indicated for

30 mins

Saphnelo: administer by IV infusion over ____ ____

Infections (URTI, bronchitis, influenza, UTI), arthralgia

common ADE for Saphnelo

calcineurin inhbiitr

Lupkynis is a ______ _____

voclosporin

Lupkynis

7.9 mg

Lupkynis is available as _____ capsules only

empty stomach

Lupkynis is given on _____ _____ every 12 hours (no less than q 8 hour)

renal, hepatic

For Lupkynis, dosing needed to be adjusted for _____ and _____ impairment and function of both need to be routinely monitored

lupus nephritis

Lupkynis is for ____ _____

LDD

Lupkynis is a ____

infections, HTN, HA, QT prolongation, diarrhea, UTI, anemia, mean GFR Dec, cough, hyperkalemia

common side effects for Lupkynis

Discontinue

Lupkynis: if a patient has BP >165/105 mmHg or hypertensive emergency, ______ therapy and initiate antihypertensive

Complement C5a Receptor Inhibitor

avacopan is a ____ ____ _____ ___

avacopan

Tavneos

ANCA-associated vasculitis

indication for avacopan

hepatic impairment

avacopan dosing needs to be monitored for _____ ______

10mg capsule

avacopan is only available as a _____ _____