Anti-TNF

Anti-TNF

Anti-TNF (Tumor Necrosis Factor) therapy refers to a class of medications that inhibit the activity of tumor necrosis factor-alpha (TNFα), a pro-inflammatory cytokine involved in systemic inflammation. These medications are primarily used to treat autoimmune diseases such as rheumatoid arthritis, Crohn's disease, ulcerative colitis, psoriasis, and ankylosing spondylitis.

Mechanism of Action

TNFα is a cytokine that plays a crucial role in the inflammatory process. It is produced by various cells, including macrophages, T-cells, and fibroblasts, and is involved in the regulation of immune cells. In autoimmune diseases, TNFα is overproduced, leading to chronic inflammation and tissue damage.

Anti-TNF drugs work by binding to TNFα, preventing it from interacting with its receptors on cell surfaces. This inhibition reduces inflammation and alters the disease process. There are several types of anti-TNF agents, including monoclonal antibodies and receptor fusion proteins.

Types of Anti-TNF Agents

1. Infliximab: A chimeric monoclonal antibody that binds to TNFα. It is administered intravenously. 2. Adalimumab: A fully human monoclonal antibody that targets TNFα. It is administered subcutaneously. 3. Etanercept: A fusion protein that acts as a decoy receptor for TNFα. It is administered subcutaneously. 4. Certolizumab pegol: A pegylated humanized antibody fragment that binds to TNFα. It is administered subcutaneously. 5. Golimumab: A human monoclonal antibody that targets TNFα. It is administered subcutaneously or intravenously.

Clinical Uses

Anti-TNF therapy is used in the management of several chronic inflammatory conditions:

- Rheumatoid Arthritis: Anti-TNF agents are often used in combination with methotrexate to reduce joint inflammation and prevent joint damage. - Inflammatory Bowel Disease: In conditions like Crohn's disease and ulcerative colitis, anti-TNF drugs help reduce intestinal inflammation and maintain remission. - Psoriasis and Psoriatic Arthritis: These agents help reduce skin lesions and joint inflammation. - Ankylosing Spondylitis: Anti-TNF therapy can reduce spinal inflammation and improve mobility.

Side Effects and Risks

While anti-TNF therapy is effective, it is associated with several potential side effects:

- Infections: Increased risk of serious infections, including tuberculosis and opportunistic infections, due to immunosuppression. - Injection Site Reactions: Pain, redness, and swelling at the injection site. - Autoantibody Formation: Some patients may develop antibodies against the drug, reducing its effectiveness. - Malignancies: There is a debated risk of increased malignancies, particularly lymphomas.

Also see

- Cytokine - Autoimmune disease - Biologic therapy - Immunosuppressive drug