The correct answer is A. Adalimumab
Monoclonal antibodies, also termed biologic agents or “biologics,” target specific inflammatory cytokines or cytokine receptors. These agents are used in the treatment of certain chronic diseases, including hepatitis C, malignant melanoma, and autoimmune disorders such as rheumatoid arthritis and multiple sclerosis Intriguingly, monoclonal antibody immunotherapy for these chronic medical disorders has been associated with a range of neuropsychiatric adverse effects, most commonly depression and psychosis.1 That immunotherapy may be associated with psychosis (albeit rarely) indirectly supports the plausibility that immunotherapy with other, different cytokines may be a potential treatment for psychosis.
A number of trials of adjunctive treatment with these agents in schizophrenia are planned or ongoing. These trials will largely focus on patients with evidence of baseline inflammation (eg, elevated blood CRP), as this approach may increase both the likelihood of response as well as the study’s signal-to-noise ratio. Studies will investigate canakinumab (anti-IL-1β mAb, natalizumab (mAb against the cell adhesion molecule α4-integrin)1, siltuximab (anti-IL-6 mAb; NCT02796859), and tocilizumab (NCT02874573).
For more on this topic, see Immunotherapy as Personalized Medicine for Schizophrenia?, on which this quiz is based.
1. Miller BJ, Buckley PF. The case for adjunctive monoclonal antibody immunotherapy in schizophrenia. Psych Clin N Am. 2016;39:187-198.