Anti-TNFs are biological factors targeting the tumor necrosis factor (TNF) and as a key term in the treatment of chronic inflammatory diseases, such as inflammatory bowel disease, rheumatoid arthritis, arthritis, ankylosing spondylitis and plaque psoriasis.
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Tumor necrosis factors (TNFs) are cytokines, a type of protein responsible for causing inflammation and which is present in high levels in patients with these diseases. Anti-TNF factors are monoclonal antibodies that bind to tumor necrosis agents and were originally studied to treat rheumatoid arthritis. They have been shown to cause remission of the disease and improve the patient’s quality of life. However, some patients do not respond to this treatment, while others lose the response, gradually, over time.
A drug can be effective when it is in sufficient concentration in the blood. The concentration of anti-TNF factors in the serum shortly before the next injection, defined as the minimum concentration, has been used to monitor the drug. Recent data have correlated a good clinical response with adequate blood concentrations of the drug in patients with inflammatory bowel disease and rheumatoid arthritis. These data are very important for the optimization of the treatment and the control of the gradual loss of response to the drug.
The loss of efficacy is usually due to the immunogenicity of the drug, which results in the production of antibodies against anti-TNF factors. These antibodies can be produced in any patient undergoing this treatment and neutralize the action of the drug through the formation of immune complexes, thereby reducing the concentration of the drug in the body. Thus, in the event of a low concentration of anti-TNF factor after measuring blood levels, subsequent measurement of antibodies to this factor is an important indicator and useful guide in determining the optimal treatment.
The administration of anti-TNF factors has made a decisive contribution to the treatment of rheumatoid arthritis and to the improvement of the quality of life of patients, however it is also associated with the occurrence of certain side effects. The best known anti-TNF factors used in clinical practice are adalimumab (brand name “Humira”), infliximab (brand name “Remicade”), etanercept (brand name “Enbrel”) etc.