Potential of tumor necrosis factor neutralization strategies in rheumatologic disorders other than rheumatoid arthritis.

OBJECTIVES

To consider the potential of tumor necrosis factor (TNF) neutralization in rheumatologic disorders other than rheumatoid arthritis (RA).

METHODS

Literature on the safety and efficacy of TNF inhibition in the treatment of non-RA arthropathies and systemic inflammatory diseases from American and European medical journals was reviewed.

RESULTS

Clinical trials, open-label studies, and case studies indicate great promise for TNF inhibitors alone or in combination with other protocols in the treatment of non-RA rheumatologic disorders. In randomized, double-blind, placebo-controlled trials of etanercept and open-label studies of infliximab in patients with psoriatic arthritis, these 2 TNF inhibitors resulted in an approximately 80% to 90% response rate. Double-blind, placebo-controlled, randomized trials also indicate an encouraging degree of efficacy in patients with ankylosing spondylitis. Preliminary evidence from open-label trials and case studies suggests that these TNF inhibitors also may be effective in the treatment of Behçet disease, Wegener granulomatosis, and sarcoidosis.

CONCLUSIONS

Neutralization of TNF may have an important role in the treatment of rheumatologic disorders other than RA.