What have we learnt from targeted anti-TNF therapy?
Anti-tumour necrosis factor (anti-TNF) therapy of patients with rheumatoid arthritis dates back to 1992, when the first proof-of-principle trials were performed in London by Maini and Feldmann. Considerable studies of the mechanism of action were performed, and insights into the way in which anti-TNF therapy delivers its benefit were obtained. In this brief review, certain aspects of knowledge acquired and the many gaps will be reviewed. Focus will be on the TNF-dependent cytokine cascade and what it means, and potential new approaches to treatment. Finally, an entertaining challenge: might many or even all unmet clinical needs be dealt with through cytokine analysis?
Feldmann
M
M
Kennedy Institute of Rheumatology Division, Imperial College, 65 Aspenlea Road, London W6 8LH, UK. m.feldmann@imperial.ac.uk
Williams
R O
RO
Paleolog
E
E
D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000276:immunology; D003072:Cognition Disorders / Q000276:immunology; D016207:Cytokines / Q000378:metabolism; D015195:Drug Design; D006801:Humans; D011183:Postoperative Complications / Q000276:immunology; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
D018501:Antirheumatic Agents; D016207:Cytokines; D014409:Tumor Necrosis Factor-alpha