Potential of tumor necrosis factor neutralization strategies in rheumatologic disorders other than rheumatoid arthritis

Objectives: To consider the potential of tumor necrosis factor (TNF) neutralization in rheumatologic disorders other than rheumatoid arthritis (RA). Methods: Literature on the safety and efficacy of TNF inhibition in the treatment of non-RA arthropathies and systemic inflammatory diseases from American and European medical journals was reviewed. Results: Clinical trials, open-label studies, and case studies indicate great promise for TNF inhibitors alone or in combination with other protocols in the treatment of non-RA rheumatologic disorders. In randomized, double-blind, placebo-controlled trials of etanercept and open-label studies of infliximab in patients with psoriatic arthritis, these 2 TNF inhibitors resulted in an approximately 80% to 90% response rate. Double-blind, placebo-controlled, randomized trials also indicate an encouraging degree of efficacy in patients with ankylosing spondylitis. Preliminary evidence from open-label trials and case studies suggests that these TNF inhibitors also may be effective in the treatment of Behcet disease, Wegener granulomatosis, and sarcoidosis. Conclusions: Neutralization of TNF may have an important role in the treatment of rheumatologic disorders other than RA.