Zanna ~ Vicki-Enbrel,

[Guest guest]

Hi Zanna

I asked the very same thing in the beginning when I was still on the

Imuran. I felt taking two immunosuppressants was too much for my

system... But I was told that Enbrel and Remicade are different because

they only target one thing. Enbrel works by inhibiting the immune

system component, anti-TNF.

Hope the following information helps...

Vicki

~~~~~~~~~~~~~~

Remicade and Enbrel are from a class of biologic response modifiers that

are genetically engineered to interfere with the autoimmune process that

develops in patients with RA. Unlike many immunosuppressant drugs,

Remicade and Enbrel have more focussed biologic targets and therefore do

not propagate as significant immune system damage. Specifically, these

drugs target immune factors such as tumor necrosis factor (TNF) and

interleukins that are thought to be primary culprits in the degenerative

cascade of RA.

~~~~~~~~~~~~~~~~~~~

The Immunosuppressant like Prednisone, Imuran, Cellcept and Methotrexate

work on the whole immune system with each on targeting more or less of

one area of it.

While they work on the inflammation and slowing the down the progression

of the disease, these drugs also affect every other aspect of immune

response, including leukocyte and lymphocyte proliferation, monocyte and

basophil counts, and cellular communication.

Cyclospoine - seems to have several immunosuppressant effects,

principally interferes with the action of helper T-lymphocytes.

Tacrolimus - seems to work by interfering with the ability of

interleukin-2 to communicate with the T-cell receptors, suppressing the

activation and replication of the T-cells.

Rapamune -  This drug, like the others, must be used in combination

with other drugs to suppress several actions of the immune system.  

Azathioprine - and a newer drug, Mycophenolate Mofetil (CellCept), have

a similar end result, though the two have different ways of achieving

it.  The outcome in both cases is the suppression of white blood cell

proliferation (B-cells, T-cells, and macrophages).  

Methotrexate - blocks an enzyme needed by the cell to live. This

interferes with the growth of certain cells, such as skin cells in

psoriasis that are growing rapidly. Since the growth of normal body

cells may also be affected by methotrexate, other effects will also

occur.

One drawback to Imuran is that, while it does suppress the white cells

activated in an immune response, it also can suppress red cell and

platelet production, which can be an unwanted side-effect.

CellCept works by limiting the division and development of white blood

cells, but seems to have little effect on other bone-marrow products.

The major side effects are gastrointestinal discomfort, and the

possibility of a lowered white count, usually reversible with reduced

dosage.

A relatively new development in immunosuppression is the use of

monoclonal antibodies to fight tissue rejection.  OKT3, ATGAM,

Simulect and Zenapax all function by binding to receptor sites on the

T-cells, thus preventing their activation. They do not suppress the

entire immune system.

A new drug, ISAtx247 manufactured by Isotechnika of Edmonton, Alberta,

Canada entered Phase-1 clinical trials August 28, 2000. The drug is

reportedly 3 time more potent than Cyclosporine and at the same time 5

times less toxic.

[Guest guest]

Thanks for the info!!