Pharmacological interactions of monoclonal antibodies

Med Clin (Barc). 2018 Aug 22;151(4):148-155. doi: 10.1016/j.medcli.2017.10.037. Epub 2017 Dec 27.
[Article in English, Spanish]

Abstract

The pharmacological interactions of biological agents are not well known. Because biologic agents are not metabolised by cytochrome P450 (CYP) enzymes and do not interact with cell membrane transporters, it is generally perceived that they are free from interactions with small molecule drugs. However, the clearance of biological agents varies depending on the modulation of the immune response or by either increasing or reducing the expression of target cells of the biological agents, which can occur through the action of multiple synthetic chemical agents. Furthermore, some biological agents may modify the metabolism of chemical drugs through their effects on the expression of P450 system enzymes.. In this review, we will provide an outline of the pharmacokinetics properties and pharmacologic interactions of biological drugs, focusing on monoclonal antibodies, and how these can interact with chemical synthesis molecules. We believe knowledge of them is important for clinicians and affects multiple clinical specialties.

Keywords: Adverse reactions; Agentes biológicos; Anticuerpos monoclonales; Biologics; Farmacodinamia; Interacciones farmacológicas; Monoclonal antibodies; Pharmacodynamics; Pharmacological interactions; Reacciones adversas.

Publication types

  • Review

MeSH terms

  • Antibodies, Monoclonal / pharmacokinetics
  • Antibodies, Monoclonal / pharmacology*
  • Biological Availability
  • Biological Products / pharmacokinetics
  • Biological Products / pharmacology
  • Cytochrome P-450 Enzyme System / metabolism
  • Cytokines / metabolism
  • Drug Interactions
  • Humans
  • Pharmaceutical Preparations / metabolism*

Substances

  • Antibodies, Monoclonal
  • Biological Products
  • Cytokines
  • Pharmaceutical Preparations
  • Cytochrome P-450 Enzyme System