Monoclonal antibodies are laboratory produced substances that can locate and bind to specific molecules such as tumor necrosis factor (TNF), a protein involved in causing the inflammation and damage of rheumatoid arthritis. Two out of the three TNF inhibitors are monoclonal proteins.
- Remicade, which is administered by intravenous infusion, uses a combination of human and mouse proteins to create a hybrid protein that is known as a chimeric monoclonal antibody.
- Humira, which is administered by injection, is produced from fully human proteins.
Producing man made proteins is an intricate process that involves placing cells in large stainless steel vats filled with nutrients to produce the specified protein. It is extensively tested to ensure purity before it is ready for patient use.
Another monoclonal protein to be approved for the treatment of rheumatoid arthritis is Rituxan. Like Remicade, it is a chimeric mouse/human monoclinal antibody that is given by intravenous infusion. Unlike Remicade, it attacks the B cells as opposed to TNF. Several new monoclonal antibodies are in the developmental stage to treat rheumatoid arthritis and other conditions.
Answers provided by Scott J. Zashin, M.D., clinical assistant professor at University of Texas Southwestern Medical School, Division of Rheumatology, in Dallas, Texas. Dr. Zashin is also an attending physician at Presbyterian Hospitals of Dallas and Plano. He is a fellow of the American College of Physicians and the American College of Rheumatology and a member of the American Medical Association. Dr. Zashin is author of Arthritis Without Pain - The Miracle Of Anti-TNF Blockers. The book is useful for anyone on one of the biologic drugs (Enbrel, Remicade, Humira) or considering the biologic drugs. Read my review of the book.