TNF inhibitors - new and old agents for rheumatoid arthritis.

The development of tumor necrosis factor (TNF) inhibitor therapy has revolutionized the treatment of rheumatoid arthritis (RA). Unfortunately, no one single agent is fully effective in every patient; different patients respond to different therapies in different ways, even to those agents with the same mechanism of action. In this regard, newer TNF inhibitor agents, such as golimumab and certolizumab pegol, are a welcome addition to the treatment armamentarium of RA. This article addresses some of the recent advances in TNF inhibitor therapy for RA, including therapy involving these two newer agents and recent recommendations about well established TNF inhibitors (infiximab, etanercept, adalimumab) that may affect various aspects of RA treatment strategies.