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Tumour necrosis factor antagonists

1. Summary Tumour necrosis factor (TNF) has been shown to play a pivotal role in immune and inflammatory responses. Inappropriate or over-expression of TNF is a hallmark of a number of diseases including rheumatoid arthritis (RA), Crohn’s disease and sepsis. Inhibition of TNF production has been shown to be beneficial in a wide range of preclinical models of inflammatory disease making inhibition of TNF production or signalling an appealing target for the development of novel anti-inflammatory drugs. Initial efforts in this area have focused on the use of TNF binding proteins (monoclonal antibodies to TNF and soluble derivatives of the two TNF receptors) as therapeutic agents. This review will outline the data supporting a role for TNF as a mediator of inflammation and will subsequently focus on the recent clinical experience with TNF inhibitors in Crohn’s disease and RA.