Tumour necrosis factor alpha inhibitors for the treatment of adult rheumatoid arthritis

Abstract

The management of patients with rheumatoid arthritis now focuses on both the relief of symptoms and the prevention of joint damage. When conventional therapies fail, adalimumab, etanercept and infliximab, inhibitors of the pro-inflammatory cytokine tumour necrosis factor alpha, can be considered. Evidence from randomised controlled studies suggests that many patients who do not respond to conventional therapy improve with adalimumab, etanercept or infliximab, particularly when these drugs are combined with methotrexate. Infusion and injection site reactions occur in some patients and the risks of infection are increased, particularly early in the treatment course. Long-term risks such as an ..