Since entering the clinic 25 years ago, biologic TNF inhibitors have transformed the outlook for people with rheumatoid arthritis and set the standard for all other targeted therapies. Despite changes to the therapeutic landscape, TNF inhibitors look set to remain an important treatment option for the foreseeable future.
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References
Feldmann, M. & Maini, R. N. Lasker Clinical Medical Research Award. TNF defined as a therapeutic target for rheumatoid arthritis and other autoimmune diseases. Nat. Med. 9, 1245–1250 (2003).
Breedveld, F. C. et al. The PREMIER study: A multicenter, randomized, double-blind clinical trial of combination therapy with adalimumab plus methotrexate versus methotrexate alone or adalimumab alone in patients with early, aggressive rheumatoid arthritis who had not had previous methotrexate treatment. Arthritis Rheum. 54, 26–37 (2006).
Klareskog, L. et al. TEMPO (Trial of Etanercept and Methotrexate with Radiographic Patient Outcomes) study investigators. Therapeutic effect of the combination of etanercept and methotrexate compared with each treatment alone in patients with rheumatoid arthritis: double-blind randomised controlled trial. Lancet 363, 675–681 (2004).
Gabay, C. et al. Tocilizumab monotherapy versus adalimumab monotherapy for treatment of rheumatoid arthritis (ADACTA): a randomised, double-blind, controlled phase 4 trial. Lancet 381, 1541–1550 (2013).
Burmester, G. R. et al. Efficacy and safety of sarilumab monotherapy versus adalimumab monotherapy for the treatment of patients with active rheumatoid arthritis (MONARCH): a randomised, double-blind, parallel-group phase III trial. Ann. Rheum. Dis. 76, 840–847 (2017).
Taylor, P. C. Pain in the joints and beyond; the challenge of rheumatoid arthritis. Lancet Rheumatol. 5, e351–e360 (2023).
Mariette, X. et al. Malignancies associated with TNF inhibitors in registries and prospective observational studies: a systematic review and metaanalysis. Ann. Rheum. Dis. 70, 1895–1904 (2011).
Ljung, L., Rantapää-Dahlqvist, S., Jacobsson, L. T. & Askling, J. Response to biological treatment and subsequent risk of coronary events in rheumatoid arthritis. Ann. Rheum. Dis. 75, 2087–2094 (2016).
Giles, J. T. et al. Cardiovascular safety of tocilizumab versus etanercept in rheumatoid arthritis: a randomized controlled trial. Arthritis Rheumatol. 72, 31–40 (2020).
Kristensen, L. E. et al. Identification of two tofacitinib subpopulations with different relative risk versus TNF inhibitors: an analysis of the open label, randomised controlled study ORAL Surveillance. Ann. Rheum. Dis. 82, 901–910 (2023).
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P.C.T. declares that he has received consulting fees from AbbVie, Biogen, Bristol Myers Squibb, Fresenius, Galapagos, Gilead Sciences, GSK, Janssen, Lilly, Nordic Pharma, Pfizer, Roche, Sanofi and UCB, and research support to the University of Oxford from Galapagos.
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Taylor, P.C. Are TNF inhibitors still the agent of choice for RA?. Nat Rev Rheumatol 19, 755–756 (2023). https://doi.org/10.1038/s41584-023-01043-y
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DOI: https://doi.org/10.1038/s41584-023-01043-y