title: Tumor necrosis factor biologics beyond psoriasis in dermatology.
abstract: BACKGROUND
  TNF-α is a cytokine essential for immune response and its receptors has been shown to be dysregulated in a variety of diseases including psoriasis vulgaris. There are a number of TNF-α inhibitors approved for psoriasis, however there is a growing body of literature supporting their use in a wide variety of dermatological conditions.
  
  
  METHODS
  The use of biologic TNF-α antagonists in conditions for which they have not yet been approved by the FDA ('off-label' uses) and the literature that supports the most appropriate agents and conditions for use. A PubMed/MEDLINE search was performed with the keywords 'TNFα antagonist', 'biologic therapy', 'off-label' and 'unapproved'. The list of references and citing articles of the articles retrieved were also used as sources. This complete list was evaluated for inclusion, based on relevance to the proposed goal of this review.
  
  
  CONCLUSIONS
  There are a large number of conditions for which biologic antagonists of TNFα are effective, beyond those already approved by the FDA. The various agents vary in their efficacy in treatment, with infliximab consistently the most effective, particularly in granulomatous diseases. Although effectiveness varies among these conditions, biologic antagonists of TNF-α are promising for the treatment of these diseases.
authors.affiliation: University of Alabama at Birmingham, Dermatology, 1530 Third Avenue South, EFH suite 414 Birmingham, AL 35294, USA.
authors.forename: Raj
authors.initials: R
authors.lastname: Patel
authors.forename: John M
authors.initials: JM
authors.lastname: Cafardi
authors.forename: Nital
authors.initials: N
authors.lastname: Patel
authors.forename: Naveed
authors.initials: N
authors.lastname: Sami
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Cafardi
mesh_terms: D000068879:Adalimumab; D000818:Animals; D061067:Antibodies, Monoclonal, Humanized / Q000494:pharmacology / Q000627:therapeutic use; D001688:Biological Products / Q000494:pharmacology / Q000627:therapeutic use*; D003880:Dermatology / Q000379:methods / Q000639:trends*; D006801:Humans; D011565:Psoriasis / Q000188:drug therapy* / Q000276:immunology; D000079424:Tumor Necrosis Factor Inhibitors; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors / Q000276:immunology; D048069:Tumor Necrosis Factors / Q000276:immunology
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D001688:Biological Products; D000079424:Tumor Necrosis Factor Inhibitors; D014409:Tumor Necrosis Factor-alpha; D048069:Tumor Necrosis Factors; D000068879:Adalimumab