ATC code L04AX | Drugs.com Drug Classes | |
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Use Erythema nodosum leprosum, multiple myeloma, myelodysplastic syndrome, acute myeloid leukaemia and other immunologic conditions Biological target TNF, IL-6, VEGF, NF-kB, etc. | ||
Immunomodulatory imide drugs (IMiDs) are a class of immunomodulatory drugs (drugs that adjust immune responses) containing an imide group. The IMiD class includes thalidomide and its analogues (lenalidomide, pomalidomide, and apremilast).
Contents
The name "IMiD" alludes to both "IMD" for "immunomodulatory drug" and the forms imide, imido-, imid-, and imid.
Generations
There are three generations of IMiDs, with each successive generation being better tolerated and more active against inflammatory and malignant conditions.
Medical use
The primary use of IMiDs in medicine is in the treatment of cancers and autoimmune diseases (including one that is a response to the infection leprosy). Indications for these agents that have received regulatory approval include:
Off-label indications for which they seem promising treatments include:
Adverse effects
The major toxicities of approved IMiDs are peripheral neuropathy, thrombocytopenia, anaemia and venous thromboembolism. There may be an increased risk of secondary malignancies, especially acute myeloid leukaemia in those receiving IMiDs.
Mechanism of action
Their mechanism of action is not entirely clear, but it is known that they inhibit the production of tumour necrosis factor, interleukin 6 and immunoglobulin G and VEGF (which leads to its anti-angiogenic effects), co-stimulates T cells and NK cells and increases interferon gamma and interleukin 2 production. Their teratogenic effects appear to be mediated by binding to cereblon. Apremilast, on the other hand, inhibits PDE4.