[Efficacy and security of tumor necrosis factor antagonists in the treatment of rheumatoid arthritis].

In the last decade, tumor necrosis factor (TNF) antagonists had supposed an important therapeutic advance in the treatment of patients with rheumatoid arthritis (RA) in both early and established RA. Three agents currently available--infliximab, etanercept, and adalimumab--have been designed to modify the biologic effects of TNF. Infliximab and adalimumab are monoclonal antibodies, whereas etanercept is a soluble protein, with different pharmacokinetic and pharmacodynamic properties, conditioning some possible adverse effects. Although comparative studies are not available, the 3 drugs have demonstrated efficacy and security, with a better quality of life of patients with RA. Infliximab, etanercept and adalimumab have been proved alone and in combination with methotrexate, with a better therapeutic, clinical, radiological and functional response in the group under combined therapy. Both clinical trials and post-market experience have demonstrated the security of these drugs, minimizing the risks with an adequate selection of patients.