Ans. is 'b' i.e., IL 1 antagonist BIOLOGIC RESPONSE MODIFIER (BRMs)* Several recombinant proteins/monoclonal antibodies that bind and inhibit cytokines, especially TNFa or IL-1 have been used succesfully in autoimmune diseases like RA, IBD, psoriosis or scleroderma.A. TNF-a inhibitorsa. Etanercept# It is a recombinant fusion protein of TNF - receptor and Fc portion of human IgG1'# It is administered by S.C. injection.b. Infliximab# It is a chimeral monoclonol antibody which binds and neutralizes TNF-a.# It is given by i.v. route.# It is indicated in RA, psoriotic arthritis, Crohn's disease, Wegener's granulomatosis and sarcoidosis.c. Adalimumab# This recombinant monoclonal anti-TNF antibody.# It is administered by S.C. route.B. IL-1 antagonistAnakinra# It is a recombinant human IL-1 receptor antagonist.# It is less effective than TNF inhibitors.# It is administered by S.C. route.C. T-cell costimulatory blockersAbatacept# It is a fusion protein that combines the extracellular domain of the molecule CTLA4 (CD 154) with the Fc portion of a human immunoglobulin.# It interfere with the interactions between antigen presenting cells and T lymphocytes. Therefore, it affects early stages in the pathogenic cascade of event in RA.D. B-cell depletersRituximab# B-cells are inflammatory cells with multiple functions in the immune response. The depletion of B cells has been shown to be effective in reducing signs and symptoms of RA and in slowing radiographic progression.# Rituximab is a chimeric monoclonal antibody that binds to the CD20 molecule on the B cell surface leading to the removal of B cells from the circulation.