Romatoloji BD, GATA, Ankara

TNF-α is a proinflammatory cytokine, which plays a crucial role in the pathogenesis of rheumatoid arthritis and a number of other inflammatory diseases. Recently, anti-TNF drugs, which antagonize the biological activity of TNF-α have started to be used in the treatment of rheumatological disorders. There are 3 anti-TNF drugs currently used in our country and throughout the world for this purpose. Of those, etanercept (Enbrel®) is a dimeric TNF receptor, and infliximab (Remicade®) and adalimumab (Humira®) are human-murine chimeric (75% human and 25% murine) and human monoclonal antibodies, respectively. In Turkey, infliximab was licensed for the treatment of rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, and Crohn's disease, etanercept for rheumatoid arthritis, ankylosing spondylitis, psoriasis, psoriatic arthritis and juvenile idiopathic arthritis and adalimumab only for rheumatoid arthritis. Although their anti-inflammatory activities are dependent on the blockade of TNF-α, they have different effects on the immune system and inflammation due to their different structures and physiological features, which determine both their clinical indications and side effects. As in all other drugs, side effects as well as clinical activity are very crucial issues.