Current state of tumour necrosis factor {alpha} blockade in Wegener's granulomatosis.
Tumour necrosis factor alpha (TNFalpha) is likely to be involved in the pathogenesis of Wegener's granulomatosis. This paper reviews published clinical trials of the anti-TNFalpha agents etanercept and infliximab with regard to their efficacy and safety in the treatment of Wegener's granulomatosis. On the basis of the high rate of adverse events, particularly an increased incidence of cancers, the use of etanercept in the management of Wegener's granulomatosis is not justified. However, the potential role for infliximab or the as yet untested adalimumab cannot be discounted. The development of novel approaches focusing on blockade of specific molecules including TNFalpha in the treatment of Wegener's granulomatosis is awaited.
Mukhtyar
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Rheumatology Department, Nuffield Orthopaedic Centre, Windmill Road, Oxford OX3 7LD, UK.
Luqmani
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D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000068800:Etanercept; D014890:Granulomatosis with Polyangiitis / Q000188:drug therapy* / Q000276:immunology; D006801:Humans; D007074:Immunoglobulin G / Q000627:therapeutic use; D000069285:Infliximab; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors* / Q000276:immunology; D014657:Vasculitis / Q000139:chemically induced
D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D000068800:Etanercept