Golimumab

• Ulcerative colitis

Golimumab is a tumor necrosis factor (TNF) blocker indicated for the treatment of adult patients with: Moderately to severely active rheumatoid arthritis (RA) in combination with methotrexate Active psoriatic arthritis (PsA) alone, or in combination with methotrexate Active ankylosing spondylitis (AS) ... Read moreGolimumab is a tumor necrosis factor (TNF) blocker indicated for the treatment of adult patients with: Moderately to severely active rheumatoid arthritis (RA) in combination with methotrexate Active psoriatic arthritis (PsA) alone, or in combination with methotrexate Active ankylosing spondylitis (AS) Moderate to severe Ulcerative colitis (UC) with an inadequate response or intolerant to prior treatment or requiring continuous steroid therapy inducing and maintaining clinical response, improving endoscopic appearance of the mucosa during induction, inducing clinical remission, achieving and sustaining clinical remission in induction responders

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Golimumab is a human monoclonal antibody that binds to both the soluble and transmembrane bioactive forms of human TNFα. This interaction prevents the binding of TNFα to its receptors, thereby inhibiting the biological activity of TNFα (a cytokine protein). There was no evidence of the golimumab antibody binding to other TNF superfamily ligands; in particular, the golimumab antibody did not bind or neutralize human lymphotoxin. Golimumab did not lyse human monocytes expressing transmembrane TNF in the presence of complement or effector cells.Elevated TNFα levels in the blood, synovium, and joints have been implicated in the pathophysiology of several chronic inflammatory diseases such as rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis. TNFα is an important mediator of the articular inflammation that is characteristic of these diseases. The exact mechanism by which golimumab treats ulcerative colitis is unknown. Golimumab modulated the in vitro biological effects mediated by TNF in several bioassays, including the expression of adhesion proteins responsible for leukocyte infiltration (E-selectin, ICAM-1 and VCAM-1) and the secretion of proinflammatory cytokines (IL-6, IL-8, G-CSF and GM-CSF).

Abatacept: Increased risk of serious infection Anakinra: Increased risk of serious infection  Live vaccines/therapeutic infectious agents: Avoid use with Golimumab

Most common adverse reactions (incidence > 5%) are upper respiratory tract infection, nasopharyngitis, injection site reactions

There are no adequate and well-controlled trials of Golimumab in pregnant women. There is no information regarding the presence of Golimumab in human milk, the effects onbreastfed infants, or the effects on milk production.

Serious Infections: Do not start Golimumab during an active infection. If an infection develops, monitor carefully, and stop Golimumab if infection becomes seriousInvasive Fungal Infections: For patients who develop a systemic illness on Golimumab, consider empiric antifungal therapy for those who reside in or travel to regions where mycoses are endemicHepatitis B Reactivation: Monitor HBV carriers during and several months after therapy. If reactivation occurs, stop Golimumab and begin antiviral therapyMalignancies: Incidence of lymphoma was greater than in the general U.S. population. Cases of other malignancies have been observed among patients receiving TNF blockersCongestive Heart Failure: Worsening, or new onset, may occur. Stop Golimumab if new or worsening symptoms occurDemyelinating Disorders: Exacerbation or new onset may occurLupus-like Syndrome: Discontinue Golimumab if symptoms developHypersensitivity Reactions: Serious systemic hypersensitivity reactions including anaphylaxis may occur

Pediatric Use: Effectiveness of Golimumab in pediatric patients less than 18 years of age has not been established.