TNF-alpha inhibitors: Treatment for inflammatory diseases

For people with inflammatory conditions, such as rheumatoid arthritis and Crohn's disease, who have tried other medications with little success, tumor necrosis factor-alpha (TNF-alpha) inhibitors may provide some relief. These drugs block TNF-alpha — a protein that's present in larger quantities in your body if you have certain inflammatory conditions. Along with the possible benefits, TNF-alpha inhibitors may cause side effects, including some that could be life-threatening. As with all medications you take, you and your doctor must balance the risks and financial cost with the potential benefits.

Available TNF-alpha inhibitors

Three TNF-alpha inhibitors are available by prescription.

Adalimumab (Humira)
Adalimumab is used alone or in combination with other drugs to treat:

• Rheumatoid arthritis
• Psoriatic arthritis
• Moderate to severe Crohn's disease

You inject adalimumab under the skin on your thighs or abdomen every other week, or sometimes weekly.

Etanercept (Enbrel)
Etanercept can be used alone or in combination with other medications for conditions such as:

• Rheumatoid arthritis
• Juvenile rheumatoid arthritis
• Psoriatic arthritis
• Psoriasis
• Ankylosing spondylitis

You inject etanercept once or twice a week under the skin of your thigh, abdomen or upper arm.

Infliximab (Remicade)
Infliximab is given as an intravenous (IV) infusion over two or three hours. You might receive two or three IV infusions over several weeks or months. For rheumatoid arthritis, the usual dosage schedule is three infusions over the first six weeks, then once every eight weeks after that.

Your doctor might prescribe infliximab if you have:

• Moderate to severe Crohn's disease
• Rheumatoid arthritis
• Psoriatic arthritis
• Ankylosing spondylitis
• Ulcerative colitis

Common side effects of TNF-alpha inhibitors

TNF-alpha inhibitors, like many medications, carry a risk of side effects — some more serious than others. Because TNF-alpha inhibitors are infused or injected into your body, you might notice a reaction at the injection site. Some common signs and symptoms of injection reactions include:

• Redness
• Itching
• Pain
• Swelling
• Bleeding
• Bruising

TNF-alpha inhibitors also may cause other side effects, including runny nose, sneezing, headache and dizziness. Tell your doctor if any of these signs and symptoms persist or are bothersome.

Each TNF-alpha inhibitor may cause different side effects. Read the information that comes with your medication carefully so that you know what to expect and when to seek medical attention. Talk to your doctor or pharmacist if you have any questions.

TNF-alpha inhibitors in the future

Clinical trials are under way to investigate the use of the three currently available TNF-alpha inhibitors, as well as others, in several other diseases. Look for possible new developments in the future. For now, talk to your doctor if you think TNF-alpha inhibitors may be of benefit to you.

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