TNFalfaestäjät

TNF-alfaestäjät, or TNF-alpha inhibitors, are a class of biologic drugs that block tumor necrosis factor alpha (TNF-α), a cytokine that drives inflammation in several autoimmune diseases. By neutralizing TNF-α or preventing its interaction with receptors, these medications reduce inflammatory signals and help control disease activity.

Major agents include monoclonal antibodies such as infliximab, adalimumab, golimumab, and certolizumab pegol, as well as the TNF receptor fusion protein etanercept. They are approved for conditions including rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, Crohn’s disease, ulcerative colitis, plaque psoriasis, and juvenile idiopathic arthritis. Dosing varies: infliximab is given by intravenous infusion, while the others are typically subcutaneous injections on regular schedules. Some patients may require combination therapy with other disease-modifying drugs.

Before starting therapy, clinicians screen for latent tuberculosis and assess hepatitis B status; appropriate vaccinations are recommended where possible. Ongoing monitoring includes watching for infections, liver function, and blood counts, as well as evaluating treatment response. Some patients may develop antibodies against the drug, which can reduce effectiveness.

Safety considerations include an increased risk of serious infections and TB reactivation, infusion or injection site reactions, and rare adverse events such as demyelinating diseases or worsening heart failure. The overall risk of malignancy remains a topic of study. Pregnancy and breastfeeding decisions are individualized, with consideration given to disease activity and treatment type.