TNF Blockers - What You Need to Know

Answers to Common Questions About TNF Blockers

Photo @ Carol Eustice

The first TNF blocker, Enbrel, was marketed in 1998. Now, there are several more and we're learning about how well the drugs work and side effects associated with them. TNF blockers are very effective for some but they are not for everyone. We offer answers to commonly asked questions about TNF blockers:

The Basics: What Are TNF Blockers and How Do They Work?

TNF blockers are sophisticated, complicated drugs, and learning how they work is important to understanding your treatment plan.

Biologic Response Modifier: What Is it?
Biological therapy, also referred to as immunotherapy or biotherapy, employ biologic response modifiers (BRMs) to stimulate or restore the ability of the immune system to fight disease and/or infection. TNF-alpha blockers are classified as biologics.

Biologics Explained
Patients who have had an unsatisfactory response to DMARDs (disease-modifying anti-rheumatic drugs), either alone or in combination with other arthritis medications, are usually good candidates for biologics.

What Is Tumor Necrosis Factor (TNF)?
A brief explanation of Tumor Necrosis Factor (TNF).

What Is a Monoclonal Antibody?
What is a monoclonal antibody? How do monoclonal antibodies work as a treatment for rheumatoid arthritis? Which of the biologic drugs are monoclonal antibodies? Are more in development?

Enbrel - What You Need to Know
Enbrel was the first anti-TNF drug and was approved in 1998.

Enbrel is derived by introducing human DNA into Chinese hamster ovary cells and creating a genetically engineered protein.

Remicade - What You Need to Know
Remicade, a monoclonal antibody which binds to and blocks tumor necrosis factor alpha (TNF-alpha), was the second TNF inhibitor to be approved by the U.S. Food and Drug Administration in 1999.

Humira - What You Need to Know
Humira was approved by the FDA in 2002. It was the third TNF blocker to be approved.

Simponi - What You Need to Know
Simponi (golimumab) is a TNF blocker approved by the FDA on April 24, 2009 for the treatment of moderate to severe rheumatoid arthritis, active psoriatic arthritis, and active ankylosing spondylitis.

Cimzia - What You Need to Know
Cimzia is the only drug in the TNF class that touts being less poisonous to cells because of its chemical properties. In addition, compared to other TNF blockers, Cimzia reportedly has a higher affinity for human TNF.

Enbrel, Remicade, and Humira - How Are They Similar and Different?
Patients are often advised to weigh the benefit and risk of any arthritis medication. In the case of TNF blockers, what are the benefits and risks which should be considered? Are there individual differences between Enbrel, Remicade, and Humira in terms of benefits or risks?

Questions You May Have About TNF Blockers

Biologic Drugs - Are Some Arthritis Patients Unsuitable Candidates for Biologic Drugs?
The medical history of some arthritis patients make them unsuitable candidates for biologic drugs such as Enbrel, Remicade, Humira, Orencia and Rituxan.

When Is It Appropriate to Switch Your TNF Blocker Drug?
If an arthritis patient is on one of the TNF blocker drugs, when is it appropriate to switch to another?

Can TNF Blockers Be Stopped When Remission Is Achieved?
TNF blockers -- Enbrel, Remicade, and Humira -- are biologic drugs with the potential for slowing the progression of rheumatoid arthritis and other inflammatory types of arthritis. If remission is achieved, can TNF blockers be stopped?

Do Biologics Prevent Joint Damage and Deformity?
Biologics, a class of drugs used to treat inflammatory types of arthritis, may prevent joint damage and deformity. What evidence exists that biologics prevent disease progression?

Serious Side Effects and Other Concerns

Is Infection a Serious Side Effect of DMARDs and Biologic Drugs?
Some patients are prone to infection while being treated with DMARDs or biologic drugs. Is infection a serious side effect of biologic drugs? What can be done to fight off infection?

Rheumatoid Arthritis Drugs Linked to Increased Risk of Infections And Cancer
TNF Blockers, specifically Humira and Remicade, reportedly increase the risk of cancer and serious infection.

Should Arthritis Patients Fear the Side Effects of Enbrel, Remicade, and Humira?
Arthritis patients are sometimes afraid of the biologic response modifiers known as TNF blockers. The side-effects can be very serious (serious infection, lymphoma etc.), so their fears are not illogical. What is the benefit vs. risk for TNF blockers?

Is It Possible to Decrease the Risk of an Allergic Reaction to Remicade?
Rheumatologist Scott Zashin explains what can be done to decrease the chance of having an allergic reaction to Remicade.

TNF Blockers and Skin Disease
The group of drugs known as TNF blockers triggers skin conditions in 25% of patients treated with the drugs.

More Information and a Quiz

Arthritis Without Pain - The Miracle of TNF Blockers
A book about TNF blockers explaining how they work and how they compare to other arthritis drugs. Read about patient success stories and how this breakthrough class of drugs has changed lives. Author is rheumatologist Scott J. Zashin, MD.

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