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[Immunology](https://durgical.com/en/immunology/) · [Transplant, tumors and immunotherapy](https://durgical.com/en/immunology/#a-transplant)

# Monoclonal antibodies and biologics: naming and targets

- Topic

Lab-made antibodies hit one target, such as TNF, CD20 or HER2; the end of the drug name tells you what kind of molecule it is.

Updated 2026-11-01

## Key points

- Classic name endings: -ximab chimeric (mouse-human), -zumab humanized, -umab fully human, -omab mouse; -cept is a receptor fusion protein; -nib is a small-molecule kinase inhibitor, not an antibody.
- Since 2022 the WHO naming scheme gives new antibodies endings such as -tug, -bart, -mig and -ment instead of -mab.
- Anti-TNF (infliximab, adalimumab, etanercept and others): screen for latent TB and hepatitis B before starting.
- Rituximab (anti-CD20) depletes B cells: hepatitis B reactivation and PML (JC virus) are key risks.
- Natalizumab (anti-α4 integrin) carries a PML risk; eculizumab (anti-C5) carries a meningococcal risk.
- Trastuzumab (anti-HER2) can cause cardiotoxicity; bevacizumab (anti-VEGF) causes hypertension, bleeding, poor wound healing and GI perforation.

## What it is

Monoclonal antibodies are identical antibodies made in the lab against a single target. They block cytokines or receptors, mark cells for destruction, or carry toxins and drugs to a cell. Fusion proteins that join a receptor to an antibody tail (-cept) work in a similar way. Knowing the target predicts both the use and the main risk.

## Key facts

- The syllable before the ending hints at the target area: -lim- immune system, -tum- tumor, -cir- cardiovascular, -kin- interleukin (older scheme).
- Antibodies can be naked (block or mark the target), conjugated to a drug or toxin, or bispecific, joining two targets such as CD19 and CD3 (blinatumomab).
- Mouse or chimeric antibodies are more likely to trigger anti-drug antibodies and infusion reactions.

## Biologics to know: target and main use

| Drug | Target | Main uses | Key risk |
| --- | --- | --- | --- |
| Infliximab, adalimumab, golimumab, certolizumab | TNF-α | Rheumatoid arthritis, Crohn disease, ulcerative colitis, psoriasis, ankylosing spondylitis | TB reactivation, serious infections, hepatitis B reactivation |
| Etanercept (-cept) | TNF (soluble receptor decoy) | Rheumatoid arthritis, psoriasis | TB reactivation, infections |
| Rituximab | CD20 (B cells) | B-cell lymphomas, CLL, rheumatoid arthritis, vasculitis | Hepatitis B reactivation, PML, infusion reactions |
| Trastuzumab | HER2 (ERBB2) | HER2-positive breast and gastric cancer | Cardiomyopathy (reduced ejection fraction) |
| Bevacizumab | VEGF-A | Colorectal, lung and ovarian cancer; some eye diseases | Hypertension, bleeding, proteinuria, poor wound healing, GI perforation |
| Cetuximab, panitumumab | EGFR | RAS wild-type colorectal cancer, head and neck cancer | Acne-like rash, low magnesium |
| Omalizumab | IgE | Severe allergic asthma, chronic urticaria | Anaphylaxis (rare) |
| Mepolizumab; dupilumab | IL-5; IL-4 receptor α | Eosinophilic asthma; atopic dermatitis and asthma | Injection-site reactions; conjunctivitis (dupilumab) |
| Tocilizumab | IL-6 receptor | Rheumatoid arthritis, giant cell arteritis, cytokine release syndrome | Infections, high lipids, liver enzyme rise |
| Ustekinumab; secukinumab | IL-12/IL-23 p40; IL-17A | Psoriasis, Crohn disease (ustekinumab), psoriatic arthritis | Infections; secukinumab can worsen inflammatory bowel disease |
| Natalizumab | α4 integrin | Multiple sclerosis, Crohn disease | PML (JC virus) |
| Eculizumab, ravulizumab | Complement C5 | Paroxysmal nocturnal hemoglobinuria, atypical HUS | Meningococcal infection |
| Denosumab | RANKL | Osteoporosis, bone metastases | Low calcium, jaw osteonecrosis |
| Abciximab | Platelet GPIIb/IIIa | Prevention of thrombosis during coronary intervention (historic) | Bleeding, thrombocytopenia |

## Clinical notes

- Before any anti-TNF or B-cell–depleting biologic, patients are screened for latent tuberculosis, hepatitis B and often hepatitis C and HIV; in Colombia the TB screen is especially important.
- Live vaccines are avoided during treatment with most biologics.

## Memory aid

Read the name from the end: -xi- part mouse, -zu- mostly human, -u- all human, -cept a receptor in disguise, -nib a small pill.

## Test yourself

Think of the answer, then tap the question to see it.

## What does the ending -zumab tell you about a monoclonal antibody?

It is humanized: mostly human, with only the antigen-binding loops from mouse.

## Which infection must be screened for before starting infliximab or adalimumab?

Latent tuberculosis (and hepatitis B), because TNF blockade can reactivate them.

## What is the target of rituximab and which viral reactivation is a major risk?

CD20 on B cells; hepatitis B reactivation (and PML from JC virus).

## What does the suffix -cept mean, and give an example?

A fusion protein of a receptor with an antibody Fc tail, such as etanercept (TNF receptor) or abatacept (CTLA-4).

## Which monoclonal antibody against complement requires meningococcal vaccination?

Eculizumab (and ravulizumab), which block C5 and the membrane attack complex.

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## Related

- [TNF-α](https://durgical.com/en/immunology/tnf/)
- [Antibody structure and isotypes (IgG, IgA, IgM, IgE, IgD)](https://durgical.com/en/immunology/antibody-structure-and-isotypes/)
- [CD markers: the table to know](https://durgical.com/en/immunology/cd-markers-the-table-to-know/)
- [Immunosuppressants by mechanism (classes)](https://durgical.com/en/immunology/immunosuppressants-by-mechanism/)
- [Tumor immunology and checkpoint inhibitors](https://durgical.com/en/immunology/tumor-immunology-and-checkpoint-inhibitors/)
- [Secondary immunodeficiency: HIV, malnutrition, drugs, asplenia](https://durgical.com/en/immunology/secondary-immunodeficiency-hiv-malnutrition-drugs-asplenia/)

## Related conditions

- [Rheumatoid arthritis](https://durgical.com/en/conditions/rheumatoid-arthritis/)
- [Crohn disease](https://durgical.com/en/conditions/crohn-disease/)
- [Tuberculosis](https://durgical.com/en/conditions/tuberculosis/)

## Microorganisms

- [Mycobacterium tuberculosis](https://durgical.com/en/microbiology/mycobacterium-tuberculosis/)
- [Hepatitis B virus](https://durgical.com/en/microbiology/hepatitis-b-virus/)
- [JC polyomavirus](https://durgical.com/en/microbiology/jc-polyomavirus/)
- [Neisseria meningitidis](https://durgical.com/en/microbiology/neisseria-meningitidis/)

## In Pharmacology

- [Infliximab](https://durgical.com/en/pharmacology/infliximab/)
- [Adalimumab](https://durgical.com/en/pharmacology/adalimumab/)
- [Etanercept](https://durgical.com/en/pharmacology/etanercept/)
- [Tocilizumab](https://durgical.com/en/pharmacology/tocilizumab/)

[← All of immunology](https://durgical.com/en/immunology/)

Educational content on the immune system; not a treatment or individual vaccination guide and no substitute for a health professional's advice. No doses are given.

Sources: [Monoclonal Antibodies](https://www.cancer.gov/about-cancer/treatment/types/immunotherapy/monoclonal-antibodies) (National Cancer Institute (NCI), 2026); [International Nonproprietary Names Programme and Classification of Medical Products](https://www.who.int/teams/health-product-and-policy-standards/inn) (World Health Organization (WHO), 2026); [Risk Factors for Meningococcal Disease](https://www.cdc.gov/meningococcal/risk-factors/index.html) (Centers for Disease Control and Prevention (CDC), 2026).

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