Safety and Efficacy of the Tumor Necrosis Factor Antagonists

Psoriasis is one of the most common systemic inflammatory diseases and affects the quality of
life of the affected persons profoundly. Further knowledge of the pathogenesis and new
biotechnological techniques have made it possible to develop new targeted therapies, such as
antibodies against tumor necrosis factor (TNF)-alpha. Today, 3 TNF inhibitors, infliximab,
adalimumab, and Etanercept, have been approved for the treatment of psoriasis arthritis,
psoriasis, and other indications like Crohn’s disease, depending on the distinct substance by
the European Medicines Agency. Golimumab was approved in September 2009 for the use in
psoriasis arthritis, respectively. These substances have added new effective treatment options
to the therapeutic armamentarium of psoriasis. To use these new treatments for the best of our
patients, it is important to know the correct application, the advantages, as well as contraindications
or possible adverse effects of the substances. This article provides an update on the
TNF-alpha inhibitors with emphasis on practical daily use. Most data are on the basis of
high-quality studies and official guidelines, but if necessary, data from recent publications or
clinical expertise have been added. In summary, with TNF inhibitors we have gained effective
new treatment options showing a favorable safety profile when paying attention to safety
aspects before and during therapy (screening, monitoring).
Semin Cutan Med Surg 29:35-47 © 2010 Elsevier Inc. All rights reserved.

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