TNFhemmere

TNFhemmere, or TNF inhibitors, are a class of biological medicines that block the activity of tumor necrosis factor alpha (TNF-α), a cytokine involved in promoting inflammation. They are used to treat several chronic inflammatory and autoimmune diseases by reducing or normalizing immune-driven tissue damage.

Most TNFhemmere are biologic agents produced by recombinant DNA technology. They include monoclonal antibodies such as infliximab, adalimumab, certolizumab pegol, and golimumab, which bind TNF-α, and the soluble TNF receptor etanercept, which acts as a decoy receptor to neutralize TNF-α. These drugs are given by subcutaneous injection or intravenous infusion, with dosing schedules varying by agent and condition.

Indications for TNFhemmere include rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, plaque psoriasis, Crohn’s disease, ulcerative colitis, and juvenile idiopathic arthritis, as well as some forms of uveitis. They may be used as first-line biologic therapy or after failure of other treatments, and are sometimes combined with conventional disease-modifying antirheumatic drugs to improve efficacy and reduce immunogenicity.

Safety and monitoring are important. TNFhemmere increase the risk of serious infections, including reactivation of latent tuberculosis; screening for TB and hepatitis B is recommended before starting treatment. Vaccination status should be reviewed, and live vaccines are usually avoided during therapy. Other potential risks include demyelinating disorders, heart failure in susceptible individuals, infusion or injection reactions, and rare malignancies. Monitoring typically includes regular blood tests and assessment for infections or adverse effects, with dose adjustments or discontinuation if needed.

Biosimilars of several TNFhemmere are available, offering similar clinical efficacy at potentially lower cost.