TNF inhibitors
2009
TNF is not the name of the latest group created by Simon Cowell but the short name of drug called anti Tumour Necrotic Factor alpha that is used for certain types of arthritis. This drug blocks the action of the molecule TNF alpha which is a messenger molecule (a cytokine) that is involved in the body’s inflammatory immune response. However, when present in excess amounts it causes destructive inflammatory processes which result in damage to the body.
Anti TNF drugs belong to a new group of drugs known as biological response modifiers. These are used to treat some autoimmune conditions, particularly arthritic conditions such as rheumatoid arthritis and ankylosing spondylitis. In terms of these disorders the inflammatory response becomes excessive resulting in damage to bone and cartilage material which causes pain and possibly disability.
Anti TNF drugs work by blocking the action of TNF alpha, which results in suppression of the inflammatory immune response and therefore reduce damage to bone and cartilage and consequently pain.
Research has shown that anti TNF drugs can reduce inflammation in arthritic conditions such as rheumatoid arthritis resulting in periods of remission in some individuals. Evidence also indicates that these drugs are more effective during the early stages of disease although others may still find relief. Although anti TNF drugs are beneficial for some they do carry some rare but serious side effects. Their long term side effects remain to be seen as they are relatively new drugs and long term clinical data is not yet available.
There are currently three anti TNF drugs approved for use in the UK and some of them are more effective for some conditions than others. Upon reviewing the evidence on anti TNF drugs, the National Institute for Health and Clinical Excellence (NICE) recommended their use for the treatment of some arthritic conditions. The drugs Adalimumab, Etanercept and Infliximab were sanctioned for use to treat rheumatoid arthritis. To treat ankylosing spondylitis, Adalimumab and Etanercept were recommended and Etanercept was approved for use in the treatment of psoriatic arthritis.
NICE guidelines also state that once a patient is prescribed an anti TNF drug that proves unsuccessful in treating their condition, doctors cannot prescribe another. However, this has been the topic of much debate recently and NICE is currently reviewing this policy so it may be subject to change.
The development of these anti TNF drugs and their relative success for some patients has led to research and development of other anti TNF drugs in the pipeline. Drugs such as Certilizumab-pegol and Tocilizumab are currently undergoing testing and approval processes. No doubt we are only seeing the start of the use of anti TNF drugs.