Table IV.
Dose modification of selected biological disease-modifying antirheumatic drugs in renal insufficiency [42–51]
| bDMARD | Mechanism of action | Dose modification in renal insufficiency |
|---|---|---|
| Adalimumab | TNF-α inhibitor | The use of the product in patients with renal insufficiency has not been studied. No recommendations can be made [42] |
| Hemodialysis: ND Peritoneal dialysis: ND CRTT: ND | ||
| Certolizumab | TNF-α inhibitor | The use of the product in patients with renal impairment has not been studied. No recommendations can be made [47] |
| Hemodialysis: ND Peritoneal dialysis: ND CRTT: ND | ||
| Etanercept | TNF-α inhibitor | Patients with renal insufficiency: NDAR – clinical experienced is limited [44] |
| Hemodialysis: ND Peritoneal dialysis: ND CRTT: ND | ||
| Golimumab | TNF-α inhibitor | The use of the product in patients with renal impairment has not been studied. No recommendations can be made [45] |
| Hemodialysis: ND Peritoneal dialysis: ND CRTT: ND | ||
| Infliximab | TNF-α inhibitor | The use of the product in patients with renal impairment has not been studied. No recommendations can be made [46] |
| Hemodialysis: ND Peritoneal dialysis: ND CRTT: ND | ||
| Rituximab | Monoclonal anti-CD20 antibody | The use of the product in patients with renal impairment has not been studied. No recommendations can be made [48] |
| Hemodialysis: ND Peritoneal dialysis: ND CRTT: ND | ||
| Tocilizumab | Anti-IL-6 receptor antibody | CrCl ≥ 50 ml/min – NDAR [50] CrCl < 50 ml/min – ND, strict monitoring of renal function is advised [50] |
| Hemodialysis: ND Peritoneal dialysis: ND CRTT: ND | ||
| Sarilumab | Anti-IL-6 receptor antibody | “Mild/moderate” RI – NDAR [51] “Severe” RI – ND [51] |
| Hemodialysis: ND Peritoneal dialysis: ND CRTT: ND | ||
| Anakinra | Anti-IL-1 receptor antagonist | CrCl 60–< 90 ml/min – NDAR [49] CrCl 30–< 60 ml/min – caution should be exercised [49] CrCl < 30 ml/min/dialysis – the administration of recommended therapeutic dose should be considered every other day [49] |
| Hemodialysis: ND Peritoneal dialysis: ND CRTT: ND | ||
| Abatacept | CD80/86-CD28 T cell co-stimulation modulator | The use of the product in patients with renal impairment has not been studied. No recommendations can be made [43] |
| Hemodialysis: ND Peritoneal dialysis: ND CRTT: ND |
bDMARD – biological disease-modifying antirheumatic drugs, CrCl – creatinine clearance, CRTT – continuous renal replacement therapy, ND – no data, NDAR – no dose adjustment required, IL – interleukin, RI – renal insufficiency, TNF-α – tumor necrosis factor α.