Clinical experience with TNF blockers

Recently, biologic agents have become available for the treatment of rheuma toid arthritis. Such agents, the so-called TNF blockers, selectively inhibi t TNF alpha a dominant proinflammatory cytokine. They allow good suppressio n of the disease activity in many patients. Even in nonresponders to conven tional disease modifying antirheumatic drugs (DMARDs) a good response may b e achieved. The anti-erosive effect appears to be excellent. Major advantag es are the fast response and good overall safety. Constitutional symptoms o ften disappear rapidly, which may contribute substantially to the gain in q uality of life. Efficacy and safety are maintained even in long-term use. B ecause of certain risks and high costs TNF-blocking agents should be reserv ed for patients who respond poorly to conventional DMARDs or do not tolerat e them.