The Use of TNF Antagonists in Rheumatic Diseases Other Than Rheumatoid Arthritis 

Marc D. Cohen, MD
Division of Rheumatology
Mayo Clinic
Jacksonville, FL   

Summary Points

• Etanercept is FDA-approved for use in psoriatic arthritis. In randomized, controlled trials, infliximab was shown to achieve an ACR 50 in 50% of patients at 16 weeks.

• Etanercept and infliximab have been shown by randomized, controlled studies to be effective in controlling disease activity and improving function in ankylosing spondylitis.

• There is anectdotal evidence of improvement with TNF antagonists in uveitis, sarcoidosis, Still’s disease, and Wegener’s granulomatosis.

Introduction

The success of TNF antagonists in the treatment of rheumatoid arthritis and the demonstration of elevated levels of tumor necrosis factor in other inflammatory diseases has led to interesting attempts to treat patients with a variety of systemic inflammatory diseases. In diseases like psoriatic arthritis and ankylosing spondylitis randomized, placebo-controlled, double-blind clinical trials have already established the efficacy of TNF antagonists. In other diseases, large, randomized, and blinded studies are awaited.