The Medical Letter on Drugs and Therapeutics
Which TNF Inhibitor for Rheumatoid Arthritis?
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The FDA has approved five tumor necrosis factor (TNF) inhibitors for treatment of moderately to severely active rheumatoid arthritis (RA). TNF-α is a pro-inflammatory cytokine involved in the pathogenesis of many systemic inflammatory disorders.

TREATMENT OF RHEUMATOID ARTHRITIS — Disease-modifying anti-rheumatic drugs (DMARDs) such as methotrexate are now used early in the treatment of RA to prevent irreversible damage to joints and minimize toxicities associated with nonsteroidal antiinflammatory drugs (NSAIDs) and corticosteroids. Biologic DMARDs, particularly the TNF inhibitors, are generally reserved for use in moderate to severe disease.1

EFFICACY — Among RA patients who have not responded to methotrexate, addition of a TNF inhibitor has usually resulted in an ACR20 response (>20% improvement) in 55%-70% of patients in controlled trials2,3 There ... more      

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Title: Which TNF Inhibitor for Rheumatoid Arthritis?
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