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Golimumab, a human monoclonal antibody, belongs to the tumor necrosis factor alpha (TNF-α) blockers class. This medication binds to soluble and transmembrane forms of human TNF-α, preventing binding with receptors. The FDA has approved golimumab for treating conditions such as moderate to severe rheumatoid arthritis (RA), psoriatic arthritis (PA), ankylosing spondylitis (AS), ulcerative colitis (UC), and polyarticular juvenile idiopathic arthritis (pcJIA). This activity discusses key aspects of golimumab usage, including its mechanism of action, adverse event profile, and optimal management strategies for patients with these inflammatory conditions, particularly those unresponsive to first-line therapies. Healthcare professionals benefit from updated knowledge regarding golimumab administration, making informed decisions, and optimizing dosage regimens to reduce adverse reactions. This program improves patient outcomes by providing healthcare professionals with evidence-based guidance on treating RA, PA, UC, and pcJIA with golimumab. This activity provides healthcare professionals with information regarding the latest therapeutic advances, allowing for better management of these challenging conditions. Objectives: Identify the mechanism of action of golimumab. Evaluate the potential adverse effects of golimumab. Determine the appropriate monitoring parameters for patients receiving golimumab. Implement effective collaboration and communication among interprofessional team members and patients to improve care coordination, optimize golimumab therapy for treating inflammatory conditions, and improve patient outcomes. Access free multiple choice questions on this topic.

Signs and Symptoms of Overdose Doses up to 10 mg/kg of intravenous golimumab have been administered in a clinical study without reports of severe adverse reactions. Management of Overdose There is no antidote for golimumab. A poison control center or medical toxicologist should be consulted for more information.[29]

Golimumab is a tumor necrosis factor-alpha (TNF-α) inhibitor targeting the human TNF-α cytokine protein and further preventing binding with its receptors. This drug is FDA-approved for treating active moderate to severe rheumatoid arthritis in sequence with first-line therapy methotrexate, active psoriatic arthritis, active ankylosing spondylitis, and patients with moderate to severe ulcerative colitis unable to achieve an adequate response to previous therapy, or patients requiring ongoing treatment with steroid. Golimumab recently received FDA approval in 2020 for its indication in the pediatric population on treating active polyarticular juvenile idiopathic arthritis and psoriatic arthritis in patients aged 2 and older. Treating patients with inflammatory and autoimmune conditions requires coordination from an interprofessional healthcare team. Immediate clinical examination and diagnosis can enhance the efficiency of treatment plans, mitigating debilitating symptoms and increasing the quality of the patient's life. The interprofessional treatment team comprises a primary care physician (PCP), a rheumatologist, a gastroenterologist, nurse practitioners, physician assistants, nurses, a physical therapist (PT), and a pharmacist. Pharmacists should verify dosing, perform drug interaction checks, and report discrepancies to the prescriber. Nurses should monitor patients for adherence and clinical response. Continuous interaction between the prescribing specialist and PCP should be maintained with their patient's care. The treatment team should also be regularly updated with the latest guidelines on their patient's disease management. The interprofessional team should thoroughly educate and counsel patients on golimumab. Patients should be aware of any potential adverse effects that may occur and be advised to report any new onset unsuspected symptoms. Golimumab administration should be performed in a healthcare setting where the interprofessional care team is prepared for immediate adverse effects such as hypersensitivity reactions (hives, pruritus, dyspnea, nausea, angioedema, urticaria, anaphylaxis). In any severe events such as anaphylaxis, the treatment should be immediately stopped, and appropriate management should be initiated.

Continuous interaction between the prescribing specialist and PCP should be maintained with their patient's care. The treatment team should also be regularly updated with the latest guidelines on their patient's disease management. The interprofessional team should thoroughly educate and counsel patients on golimumab. Patients should be aware of any potential adverse effects that may occur and be advised to report any new onset unsuspected symptoms. Golimumab administration should be performed in a healthcare setting where the interprofessional care team is prepared for immediate adverse effects such as hypersensitivity reactions (hives, pruritus, dyspnea, nausea, angioedema, urticaria, anaphylaxis). In any severe events such as anaphylaxis, the treatment should be immediately stopped, and appropriate management should be initiated. While treating patients with golimumab, the healthcare team should monitor the patients' complete blood count, liver enzymes, and TB test before initiating the treatment and routinely afterward. TB screening with a tuberculin skin test (TST) or interferon-γ release assay (IGRA) should be performed on all patients. Patients who present a positive TB test should receive management for TB before initiating treatment with golimumab. Patients with a history of HBV receiving golimumab should routinely be monitored for HBV reactivation and discontinue therapy if reactivation does ensue. The team should discuss the treatment's potential benefits and risks with all patients planning to start golimumab therapy. Patients should be informed about the box warnings indicating an increased risk of potentially severe infections and malignancy. Patients should immediately report any new onset constitution symptoms indicative of severe infections to their PCP to prevent complications, hospitalization, and potential mortality. An interprofessional team approach and communication among clinicians (MDs, DOs, NPs, PAs), rheumatologists, pharmacists, and nurses is crucial to increasing medication compliance further, decreasing potential adverse effects, and improving disease course and quality of life.[30]