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[Anticytokine therapy].

L Naumann1, E Feist, G-R Burmester

  • 1Medizinische Klinik mit Schwerpunkt für Rheumatologie und klinische Immunologie, Charité - Universitätsmedizin Berlin, Campus Mitte, Berlin.

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Anticytokine therapies, like tumor necrosis factor (TNF)-α antagonists, are effective for chronic inflammatory diseases but require careful screening for infections. Further drug development is needed for sustained remission.

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Area of Science:

  • Immunology
  • Pharmacology
  • Rheumatology

Context:

  • Anticytokine therapies have transformed chronic inflammatory disease treatment, especially autoimmune conditions like rheumatoid arthritis.
  • Tumor necrosis factor (TNF)-α antagonists, introduced in the 1990s, remain a primary anticytokine therapy with five agents available.
  • Recent advancements include blockade of other cytokines like interleukin (IL)-1, IL-6, and IL-12/23.

Purpose:

  • To review the current landscape of anticytokine therapies for chronic inflammatory and autoimmune diseases.
  • To highlight the efficacy, safety profile, and limitations of existing anticytokine treatments.
  • To underscore the need for further development of anticytokine drugs.

Summary:

  • Anticytokine therapies, including TNF-α antagonists, offer rapid onset and high response rates for inflammatory diseases.
  • While generally well-tolerated, these therapies carry risks of infections such as tuberculosis and hepatitis B reactivation.
  • Mandatory pre-therapy screening and ongoing monitoring are crucial for patient safety.

Impact:

  • Anticytokine therapies have significantly improved patient outcomes in rheumatology, dermatology, and gastroenterology.
  • The risk of infections necessitates vigilant patient management and screening protocols.
  • Continued research and development are essential to optimize anticytokine treatments for long-term disease control.