TNF alpha Inhibitor and blocker

TNF alpha is a protein that the body produces during the inflammatory response, the body's reaction to injury. TNF alpha promotes the inflammation and its associated fever and signs (pain, tenderness, and swelling) in several inflammatory conditions including rheumatoid arthritis and ankylosing spondylitis. For more information on autoimmune diseases.

TNF blocker side effects
TNF alpha antagonists are effective in the treatment of chronic inflammatory joint disease. Despite a good overall safety profile, they can induce a number of side effects, including autoimmunity and infections. A link between TNF alpha antagonists and vasculitides has been suggested. A major concern surrounding the use of TNF-alpha inhibitors is their potential to increase the risk of opportunistic infections, particularly tuberculosis.
   Granuloma annulare skin lesions have developed in patients during anti-tumor necrosis factor (TNF) therapy. Optic neuritis has been reported in some patients taking TNF blockers.

Optic neuritis occurring with anti-tumour necrosis factor {alpha} therapy.
Ann Rheum Dis. 2007 Sep;66(9):1255-8. MD, Professor in Rheumatology, GATA Romatoloji BD, 06018, Etlik, Ankara, Turkey.
Various demyelinating disorders have been reported in association with anti-tumour necrosis factor alpha TNFalpha agents. The objective of this study was to review the occurrence, clinical features and outcome of optic neuritis during treatment with anti-TNFalpha agents. Discussion: Patients being treated with a TNFalpha antagonist should be closely monitored for the development of ophthalmological or neurological signs and symptoms. Furthermore, consideration should be given to avoiding such therapies in patients with a history of demyelinating disease. If clinical evaluation leads to the diagnosis of optic neuritis, discontinuation of the medication and institution of steroid treatment should be a priority.

TNF inhibitors for rheumatoid arthritis
Three TNF-alpha antagonists are available for the treatment of rheumatoid arthritis: Etanecerpt, infliximab, and Adalimumab.
   Etanercept is a recombinant TNF-alpha receptor Fc fusion protein that binds soluble TNF-alpha, thereby rendering TNF-alpha unavailable to bind cell surface TNF-alpha receptors. Subcutaneous injection is administered twice weekly. Etanercept may be used in combination with methotrexate. Etanercept is a synthetic protein that binds to TNF alpha. It thereby acts like a sponge to remove most of the TNF alpha molecules from the joints and blood. This prevents TNF alpha from promoting inflammation and the fever, pain, tenderness and swelling of joints in patients with rheumatoid or psoriatic arthritis and ankylosing spondylitis.
   Infliximab reduces the amount of active tumour necrosis factor alpha in the body by binding to it and preventing it from signaling the receptors for TNF alpha on the surface of cells.
   Adalimumab, a fully humanized monoclonal antibody, is the newest TNF-alpha antagonist approved for the treatment of rheumatoid arthritis and is administered subcutaneously every 2 weeks. Cases of bone marrow suppression and elevation of serum transaminase levels have been reported.

TNF inhibitor

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