Table of ContentsView AllTable of ContentsWhat They DoHow They’re MadeFor Autoimmune DiseasesFor Non-Autoimmune DiseasesSide Effects
Table of ContentsView All
View All
Table of Contents
What They Do
How They’re Made
For Autoimmune Diseases
For Non-Autoimmune Diseases
Side Effects
MOLEKUUL / SCIENCE PHOTO LIBRARY / Getty Images
What Monoclonal Antibodies Do
Monoclonalantibodies are laboratory-produced antibodies designed to locate and bind to certain molecules, rendering them neutral in a similar way.
First developed in the 1970s, dozens of monoclonal antibody therapies are available today.
They fall into three main categories:
To develop an effective antibody treatment, researchers first have to identify the specific antigen causing the problem, then engineer antibodies to target it. Once a successful antibody is produced, researchers then replicate—or clone—the antibodies.
How Monoclonal Antibodies Are Made
These include:
Producing these man-made proteins is an intricate process that involves placing cells in large stainless steel vats filled with nutrients. Monoclonal antibodies are extensively tested to ensure purity before they are ready for patient use.
Use for AI Arthritis and Other AI Diseases
Certain diseases are autoimmune in nature. They cause symptoms because the body mistakenly launches an attack on healthy tissue as if is a harmful invader.
Severalcytokineproteins have been identified as contributing to the inflammatory process involved in arthritic and other autoimmune conditions. Monoclonal antibodies have been developed to target these proteins.
What Are Autoimmune Diseases?
TNF Inhibitors
The first anti-inflammatory monoclonal antibodies developed to treat certain types of arthritis inhibittumor necrosis factor (TNF), a protein involved in causing the inflammation and damage of rheumatoid arthritis.
TNF inhibitorsare commonly prescribed for people with RA after treatment with methotrexate alone doesn’t adequately bring the disease into remission.They are also used to treat some other non-arthritic conditions, including certain gastrointestinal diseases.
TNF inhibitors include:
How Are Enbrel, Remicade, and Humira Different?
Interleukin Blockers
Interleukins (IL), a type of cytokine, plays essential roles in the activation and differentiation of immune cells. There are at least 40 variants of interleukins involved in the human immune system.
Overproduction of IL-6 is linked to the development of joint pain and inflammation in rheumatoid arthritis. Monoclonal antibodies known as IL-6 inhibitors are used in the treatment of RA and polymyalgia rheumatica (PMR).
IL-6 receptor antagonists approved for the treatment of RA or patients who did not respond to one or moredisease-modifying antirheumatic drugs (DMARDs)or some patients with polymyalgia rheumatica (PMR) include:
Other Targets
Monoclonal antibody therapies have been developed that target other proteins involved in the inflammation process. Drugs used to treat RA include:
Use for Non-Autoimmune Diseases
In addition to treating inflammatory autoimmune diseases like RA, monoclonal antibodies are used to treat cancer and certain infectious diseases.
Cancer
Incancer treatment, monoclonal antibodies are targeted to attack specific types of cancer cells, depending on the type ofmalignancy.
They work in two ways:
Besides Rituxan, some examples of monoclonal antibodies used for cancer include Avastin (bevacizumab), Herceptin (trastuzumab), and Vectibix (panitumumab).
Monoclonal Antibodies for Leukemia and Lymphoma
Viral Infections
Monoclonal antibodies can be used as passiveimmunotherapy.
Monoclonal antibody drugs approved for the treatment of Ebola virus disease includeInmazeb(atoltivimab, maftivimab, and odesivimab-ebgn) and Ebanga (Ansuvimab-zykl).
Side Effects of Monoclonal Antibodies
Monoclonal antibodies can have some seriousside effectsand risks. Individual side effects can vary from drug to drug, but many are similar.
In the case of autoimmune types of arthritis in particular, some of the side effects of monoclonal antibodies can overlap with those you have come to expect of the disease itself. Don’t let that prevent you from bringing them to your healthcare provider’s attention if you experience them.
Needle Site Reactions
The most common side effect of monoclonal antibody treatment involves irritation or infection at the injection site. If you experience any of these side effects where you received your injection orinfusion, tell your healthcare provider:
How Biologic Therapy Works
Flu-Like Symptoms
Monoclonal antibodies are intended to trigger the immune system and, in doing so, the body may respond with flu-like symptoms. Talk to your healthcare provider if you experience any of the following in the days after monoclonal antibody treatment:
Cytokine Release Syndrome
Cytokines are immune substances with a wide array of functions in the body. A sudden increase in their levels following monoclonal antibody treatment can cause troubling side effects.
Let your healthcare provider know if you experience any of these symptoms in the days following treatment with monoclonal antibodies:
Capillary Leak Syndrome
Some monoclonal antibodies can cause fluid and proteins to leak out of tiny blood vessels and flow into surrounding tissues. Known ascapillaryleak syndrome, this can result in dangerously low blood pressure and lead to multiple organ failure andshock.
Other Side Effects and Warnings
Monoclonal antibodies can cause mild to severe allergic reactions and other concerns, including:
When to Call 911Monoclonal antibody therapy can cause a life-threatening allergic reaction known asanaphylaxis.Symptoms of anaphylaxis include:Dizziness or faintingItching, hives, redness, or swelling of the skinMouth itching or swelling of the lips or tongueTight or itchy throat, trouble swallowing, or swelling of the back of the throatShortness of breath, coughing, wheezing, chest pain or tightnessSneezing, stuffy nose, runny noseVomiting, diarrhea, or stomach crampsWeak pulseIf you suspect you or someone you are with is experiencing an anaphylactic reaction, seek immediate medical help.
When to Call 911
Monoclonal antibody therapy can cause a life-threatening allergic reaction known asanaphylaxis.Symptoms of anaphylaxis include:Dizziness or faintingItching, hives, redness, or swelling of the skinMouth itching or swelling of the lips or tongueTight or itchy throat, trouble swallowing, or swelling of the back of the throatShortness of breath, coughing, wheezing, chest pain or tightnessSneezing, stuffy nose, runny noseVomiting, diarrhea, or stomach crampsWeak pulseIf you suspect you or someone you are with is experiencing an anaphylactic reaction, seek immediate medical help.
Monoclonal antibody therapy can cause a life-threatening allergic reaction known asanaphylaxis.
Symptoms of anaphylaxis include:
If you suspect you or someone you are with is experiencing an anaphylactic reaction, seek immediate medical help.
19 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.NIH: National Cancer Institute.Monoclonal antibodies.American Cancer Society.Monoclonal antibodies and their side effects.Mallbris L, Davies J, Glasebrook A, Tang Y, Glaesner W, Nickoloff BJ.Molecular Insights into Fully Human and Humanized Monoclonal Antibodies: What are the Differences and Should Dermatologists Care?J Clin Aesthet Dermatol; 9(7):13–5.Tanaka T, Hishitani Y, Ogata A.Monoclonal antibodies in rheumatoid arthritis: comparative effectiveness of tocilizumab with tumor necrosis factor inhibitors.Biologics. 2014;8:141-53. doi:10.2147/BTT.S37509Singh JA, Saag KG, Bridges SL Jr, et al.2015 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis.Arthritis Rheumatol. 2016;68(1):1-26. doi:10.1002/art.39480American Academy of Rheumatology.Certolizumab Pegol (Cimzia).U.S. National Library of Medicine: Medline Plus.Adalimumab injection.American College of Rheumatology.Infliximab (Remicade).U.S. National Library of Medicine: MedlinePlus.Golimumab injection.Justiz Vaillant AA, Qurie A.Interleukin.StatPearls[Internet].American College of Rheumatology.Tocilizumab (Actemra).Food and Drug Administration.Kevzara label.American College of Rheumatology.Rituximab (Rituxan and MabThera).Chiu YG, Ritchlin CT.Denosumab: targeting the RANKL pathway to treat rheumatoid arthritis.Expert Opin Biol Ther. 2017;17(1):119-128. doi:10.1080/14712598.2017.1263614American College of Rheumatology.Denosumab (Prolia).Pelegrin M, Naranjo-Gomez M, Piechaczyk M.Antiviral Monoclonal Antibodies: Can They Be More Than Simple Neutralizing Agents?Trends Microbiol. 2015;23(10):653-665. doi:10.1016/j.tim.2015.07.005Centers for Disease Control and Prevention.Ebola disease.Centers for Medicare & Medicaid Services.COVID-19 Monoclonal Antibodies.U.S. National Library of Medicine: MedlinePlus.Anaphylaxis.
19 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.NIH: National Cancer Institute.Monoclonal antibodies.American Cancer Society.Monoclonal antibodies and their side effects.Mallbris L, Davies J, Glasebrook A, Tang Y, Glaesner W, Nickoloff BJ.Molecular Insights into Fully Human and Humanized Monoclonal Antibodies: What are the Differences and Should Dermatologists Care?J Clin Aesthet Dermatol; 9(7):13–5.Tanaka T, Hishitani Y, Ogata A.Monoclonal antibodies in rheumatoid arthritis: comparative effectiveness of tocilizumab with tumor necrosis factor inhibitors.Biologics. 2014;8:141-53. doi:10.2147/BTT.S37509Singh JA, Saag KG, Bridges SL Jr, et al.2015 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis.Arthritis Rheumatol. 2016;68(1):1-26. doi:10.1002/art.39480American Academy of Rheumatology.Certolizumab Pegol (Cimzia).U.S. National Library of Medicine: Medline Plus.Adalimumab injection.American College of Rheumatology.Infliximab (Remicade).U.S. National Library of Medicine: MedlinePlus.Golimumab injection.Justiz Vaillant AA, Qurie A.Interleukin.StatPearls[Internet].American College of Rheumatology.Tocilizumab (Actemra).Food and Drug Administration.Kevzara label.American College of Rheumatology.Rituximab (Rituxan and MabThera).Chiu YG, Ritchlin CT.Denosumab: targeting the RANKL pathway to treat rheumatoid arthritis.Expert Opin Biol Ther. 2017;17(1):119-128. doi:10.1080/14712598.2017.1263614American College of Rheumatology.Denosumab (Prolia).Pelegrin M, Naranjo-Gomez M, Piechaczyk M.Antiviral Monoclonal Antibodies: Can They Be More Than Simple Neutralizing Agents?Trends Microbiol. 2015;23(10):653-665. doi:10.1016/j.tim.2015.07.005Centers for Disease Control and Prevention.Ebola disease.Centers for Medicare & Medicaid Services.COVID-19 Monoclonal Antibodies.U.S. National Library of Medicine: MedlinePlus.Anaphylaxis.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
NIH: National Cancer Institute.Monoclonal antibodies.American Cancer Society.Monoclonal antibodies and their side effects.Mallbris L, Davies J, Glasebrook A, Tang Y, Glaesner W, Nickoloff BJ.Molecular Insights into Fully Human and Humanized Monoclonal Antibodies: What are the Differences and Should Dermatologists Care?J Clin Aesthet Dermatol; 9(7):13–5.Tanaka T, Hishitani Y, Ogata A.Monoclonal antibodies in rheumatoid arthritis: comparative effectiveness of tocilizumab with tumor necrosis factor inhibitors.Biologics. 2014;8:141-53. doi:10.2147/BTT.S37509Singh JA, Saag KG, Bridges SL Jr, et al.2015 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis.Arthritis Rheumatol. 2016;68(1):1-26. doi:10.1002/art.39480American Academy of Rheumatology.Certolizumab Pegol (Cimzia).U.S. National Library of Medicine: Medline Plus.Adalimumab injection.American College of Rheumatology.Infliximab (Remicade).U.S. National Library of Medicine: MedlinePlus.Golimumab injection.Justiz Vaillant AA, Qurie A.Interleukin.StatPearls[Internet].American College of Rheumatology.Tocilizumab (Actemra).Food and Drug Administration.Kevzara label.American College of Rheumatology.Rituximab (Rituxan and MabThera).Chiu YG, Ritchlin CT.Denosumab: targeting the RANKL pathway to treat rheumatoid arthritis.Expert Opin Biol Ther. 2017;17(1):119-128. doi:10.1080/14712598.2017.1263614American College of Rheumatology.Denosumab (Prolia).Pelegrin M, Naranjo-Gomez M, Piechaczyk M.Antiviral Monoclonal Antibodies: Can They Be More Than Simple Neutralizing Agents?Trends Microbiol. 2015;23(10):653-665. doi:10.1016/j.tim.2015.07.005Centers for Disease Control and Prevention.Ebola disease.Centers for Medicare & Medicaid Services.COVID-19 Monoclonal Antibodies.U.S. National Library of Medicine: MedlinePlus.Anaphylaxis.
NIH: National Cancer Institute.Monoclonal antibodies.
American Cancer Society.Monoclonal antibodies and their side effects.
Mallbris L, Davies J, Glasebrook A, Tang Y, Glaesner W, Nickoloff BJ.Molecular Insights into Fully Human and Humanized Monoclonal Antibodies: What are the Differences and Should Dermatologists Care?J Clin Aesthet Dermatol; 9(7):13–5.
Tanaka T, Hishitani Y, Ogata A.Monoclonal antibodies in rheumatoid arthritis: comparative effectiveness of tocilizumab with tumor necrosis factor inhibitors.Biologics. 2014;8:141-53. doi:10.2147/BTT.S37509
Singh JA, Saag KG, Bridges SL Jr, et al.2015 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis.Arthritis Rheumatol. 2016;68(1):1-26. doi:10.1002/art.39480
American Academy of Rheumatology.Certolizumab Pegol (Cimzia).
U.S. National Library of Medicine: Medline Plus.Adalimumab injection.
American College of Rheumatology.Infliximab (Remicade).
U.S. National Library of Medicine: MedlinePlus.Golimumab injection.
Justiz Vaillant AA, Qurie A.Interleukin.StatPearls[Internet].
American College of Rheumatology.Tocilizumab (Actemra).
Food and Drug Administration.Kevzara label.
American College of Rheumatology.Rituximab (Rituxan and MabThera).
Chiu YG, Ritchlin CT.Denosumab: targeting the RANKL pathway to treat rheumatoid arthritis.Expert Opin Biol Ther. 2017;17(1):119-128. doi:10.1080/14712598.2017.1263614
American College of Rheumatology.Denosumab (Prolia).
Pelegrin M, Naranjo-Gomez M, Piechaczyk M.Antiviral Monoclonal Antibodies: Can They Be More Than Simple Neutralizing Agents?Trends Microbiol. 2015;23(10):653-665. doi:10.1016/j.tim.2015.07.005
Centers for Disease Control and Prevention.Ebola disease.
Centers for Medicare & Medicaid Services.COVID-19 Monoclonal Antibodies.
U.S. National Library of Medicine: MedlinePlus.Anaphylaxis.
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