Development of TNF inhibitor therapies for the treatment of rheumatoid arthritis.

The recognition of tumor necrosis factor-alpha (TNF-alpha) as an important mediator of pathogenesis in rheumatoid arthritis (RA) led to the development of TNF inhibitors (TNFIs), which are a significant advance in the treatment of this debilitating disease. TNFIs revolutionized RA clinical practice, providing broader treatment options and establishing low disease activity and remission as achievable goals for many patients. Numerous clinical trials have shown that TNFIs are very effective, either as combination therapy or as monotherapy, in reducing the signs and symptoms of disease and slowing or inhibiting radiographic joint damage progression. Despite some adverse effects relating most frequently to infections and skin reactions, TNFIs are generally well tolerated in most patients and are widely recommended in clinical practice, in combination with good clinical judgment and individualized patient care.