Tumour necrosis factor-alpha as a new therapeutic target for rheumatoid arthritis: an update

In rheumatoid arthritis (RA), the conventional therapies (first-line, second-line, third-line drugs) provide more or less effective symptomatic relief for a decade or so from the onset of the disease. However, the chronic inflammatory destructive processes involving connective tissue, cartilage and bone with their attendant disability progress relentlessly in majority of patients. Secondly, use of 'second-line' and 'third-line' drugs in RA are limited due to their side effects. Studies in animals and RA patients have confirmed that tumour necrosis factor-alpha (TNFalpha), an inflammatory cytokine, is of major importance in the rheumatoid disease process and thus, it might be an effective therapeutic target in RA. Animal model experiments and clinical trials were conducted with anti-TNFalpha monoclonal antibody (anti-TNFalpha MoAb) in RA recently. This anti-TNFalpha MoAb therapy was found to be both effective and safe which documented the coming-of-age of cytokine-based immunointervention in RA. Researchers are optimistic that modern medicine would certainly witness the application of this noble immunotherapy enabling to selectively target cytokines, e.g. TNFalpha, in RA as well as in other inflammatory autoimmune diseases in the near future.