STEPTRACKERIMMUNOLOGY + PHARMACOLOGY | DRUGS & ANTIBODIES | RAPID-FIRE REVIEW

Immunology Drugs & Antibodies

Every immunologic drug in one table — its target, main use and the signature risk to remember — linked to the full pages.

FOCUS ON
Group by where the drug acts: T-cell signaling (calcineurin, mTOR, IL-2R, costimulation), nucleotide synthesis (mycophenolate, azathioprine, methotrexate), cytokines (TNF, IL-1, IL-6, IL-17, IL-12/23, IL-4, IL-5, IgE), cells (CD20, CD52, CD38, integrins), complement (C5), checkpoints (CTLA-4, PD-1, PD-L1) and replacement (IVIG, recombinant cytokines). Toxicities follow mechanism: lost defense → specific infection (TB, HBV, PML, Neisseria, zoster); lost brake → autoimmunity. Full pages: 7.02 and 7.03.
DRUG
TARGET
MAIN USE · SIGNATURE RISK
PAGE
Cyclosporine
Calcineurin (cyclophilin)
Transplant · nephrotoxicity, gingival hyperplasia, hirsutism
7.02
Tacrolimus
Calcineurin (FKBP12)
Transplant · nephrotoxicity, diabetes, tremor
7.02
Sirolimus · everolimus
mTOR (FKBP12)
Kidney transplant, stents · hyperlipidemia, cytopenias, poor wound healing
7.02
Mycophenolate
IMP dehydrogenase
Transplant, lupus nephritis · GI upset, cytopenias, teratogen
7.02
Azathioprine
Purine synthesis (6-MP)
Transplant, IBD · marrow toxicity (TPMT, allopurinol)
7.02
Basiliximab · ATG
IL-2Rα (CD25) · T cells
Transplant induction · cytokine release (ATG)
7.02
Abatacept · belatacept
CD80/86 (CTLA-4-Ig)
RA · kidney transplant; PTLD (EBV-negative)
7.02
Infliximab · adalimumab · etanercept
TNF-α
RA, IBD (not etanercept), psoriasis · TB and HBV reactivation
7.03
Anakinra · canakinumab
IL-1R · IL-1β
Periodic fevers, Still disease, gout
7.03
Tocilizumab
IL-6 receptor
RA, giant cell arteritis, CRS
7.03
Secukinumab · ustekinumab · guselkumab
IL-17A · IL-12/23 p40 · IL-23
Psoriasis, PsA, AS, Crohn · Candida, IBD flares (IL-17)
7.03
Dupilumab · mepolizumab · omalizumab
IL-4Rα · IL-5 · IgE
Atopic dermatitis, asthma · eosinophilic asthma · allergic asthma
7.03
Rituximab
CD20
Lymphoma, RA, vasculitis · HBV reactivation, PML
7.03
Natalizumab · vedolizumab
α4 integrin · α4β7
MS, Crohn · PML (natalizumab)
7.03
Eculizumab
C5
PNH, aHUS · meningococcal infection
2.02
Ipilimumab · nivolumab · pembrolizumab
CTLA-4 · PD-1
Melanoma, lung, RCC · immune-related colitis, thyroiditis, hypophysitis
7.03
JAK inhibitors
JAK1/2/3
RA, UC, GVHD · zoster, thrombosis
3.05
IVIG
Pooled IgG
XLA, CVID, ITP, Kawasaki, GBS · aseptic meningitis, thrombosis, anaphylaxis in IgA deficiency
6.01
Anti-D immune globulin
Fetal Rh(D) RBCs
Prevents maternal sensitization
4.02
IFN-β · IFN-γ · IFN-α
Interferon receptors
MS · CGD · historic HBV/HCV, some cancers
3.05
Glucocorticoids
NF-κB, AP-1
Nearly everything · infections, bone loss, hyperglycemia, adrenal suppression
7.02

Mechanism — why the side effect fits the target

Block TNF→ granulomas fail → TB
Block C5→ no MAC → Neisseria
Block α4 integrin→ no CNS surveillance → PML
Block CTLA-4/PD-1→ no brakes → autoimmunity

Before you start

DRUG
CHECK
REASON
TNF inhibitors, JAKi
IGRA/PPD, HBV
Reactivation
Rituximab
HBsAg, anti-HBc
Fulminant hepatitis
Azathioprine
TPMT
Marrow toxicity
Eculizumab
Meningococcal vaccines
Neisseria
Natalizumab
JCV antibody
PML

How it's tested

COMMON CONFUSIONDrug name endings: -cept = receptor fusion protein (etanercept, abatacept); -mab = monoclonal antibody; -tinib/-citinib = small-molecule kinase inhibitor.
THE TRAPIVIG in a patient with IgA deficiency can cause anaphylaxis — use IgA-depleted products.
YOUR APPROACHName → target → indication → expected infection or autoimmunity → screening step.

If you see… think…

Gum overgrowth → cyclosporine
Post-transplant diabetes → tacrolimus
Hyperlipidemia, mouth ulcers → sirolimus
TB reactivation → TNF-α inhibitor
PML → natalizumab, rituximab
Meningococcal sepsis → eculizumab
Colitis and hypophysitis → ipilimumab
Zoster and thrombosis → JAK inhibitors
Hemorrhagic cystitis → cyclophosphamide
Marrow toxicity with allopurinol → azathioprine