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Development of anti-TNF therapy for rheumatoid arthritis

Nature Reviews Immunology volume 2, pages 364–371 (2002)Cite this article

Abstract

The aetiology of systemic, autoimmune, chronic inflammatory diseases — such as rheumatoid arthritis — is not known, and their pathogenesis is complex and multifactorial. However, progress in the characterization of intercellular mediators — proteins that are now known as cytokines — has led to the realization that one cytokine, tumour-necrosis factor (TNF; previously known as TNF-α), has an important role in the pathogenesis of rheumatoid arthritis. This discovery heralded a new era of targeted and highly effective therapeutics for rheumatoid arthritis and, subsequently, other chronic inflammatory diseases.

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Figure 1: The cytokine network in rheumatoid arthritis.
Figure 2: Progress in clinical trials — 1992–1997.
Figure 3: Anti-TNF biologicals.

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Acknowledgements

This history of anti-TNF therapy owes its existence to the research of a great many talented and dedicated scientists, both basic and clinical, all of whose work cannot be cited in this type of review. It also owes its existence to long-term dedicated collaborators, chiefly R. Maini, with whom it has been a great privilege and pleasure to work in this field for 16 years, F. Brennan and many other scientists at KIR, and J. N. Woody of Centocor, but also to many cooperating clinicians. An important group in research is the patients, who are keen to take part in clinical trials, even if it is only for the benefit of future generations of patients. The work that led to the development of the principle of anti-TNF therapy was nearly entirely funded by the Arthritis Research Campaign (ARC) in the United Kingdom. Its long-term investment in this field since 1986 has been rewarded by the benefits to its patient supporters, which will increase following the positive NICE evaluation of anti-TNF therapy.

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Authors and Affiliations

  1. the Rheumatology Division, Kennedy Institute, Faculty of Medicine, Imperial College School of Medicine, ARC Building, 1 Aspenlea Road, London, W6 8LH, UK

    Marc Feldmann

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  1. Marc Feldmann
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DATABASES

Locuslink

CD4

collagen type II

EPO

G-CSF

GM-CSF

IFN-α

IFN-β

IFN-γ

IL-1

IL-6

IL-8

IL-12

IL-15

IL-17

IL-18

LT

Tgfβ1

TNF

VEGF

Medscape DrugInfo

etanercept

infliximab

methotrexate

OMIM

ankylosing spondylitis

Crohn's disease

juvenile rheumatoid arthritis

psoriasis

rheumatoid arthritis

FURTHER INFORMATION

Arthritis Research

Arthritis Research Campaign

Cytokine Reference

Encyclopedia of Life Sciences

tumour-necrosis factors

rheumatoid arthritis

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Feldmann, M. Development of anti-TNF therapy for rheumatoid arthritis. Nat Rev Immunol 2, 364–371 (2002). https://doi.org/10.1038/nri802

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