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abatacept + adalimumab + etanercept + tocilizumab

Development stage: Discontinued
Lead developer: Bristol Myers Squibb
Modality: Fc-Fusion Proteins → Carrier/Scaffold Proteins → Recombinant Proteins and Enzymes, Monoclonal Antibodies → Antibody-Based Therapeutics
Administration: Intravenous, Subcutaneous

Overview

This is a combination of four biologic disease-modifying antirheumatic drugs (DMARDs) that are not typically used together simultaneously due to safety concerns. Each component has a different mechanism of action: abatacept is a T-cell costimulatory blocker, adalimumab is a TNF inhibitor, etanercept is a TNF inhibitor, and tocilizumab is an IL-6 receptor antagonist. Combination biologic therapy has shown increased risk of adverse events, particularly infections, with no clear advantage in efficacy compared to monotherapy in clinical trials.

Targets

CD80 (T-lymphocyte activation antigen CD80)LTA (Lymphotoxin-alpha)CD86 (T-lymphocyte activation antigen CD86)TNFA (Tumor necrosis factor alpha (soluble))IL-6R (Interleukin-6 receptor subunit alpha)

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