Bechman, K;
Attipoe, L;
Ciurtin, C;
(2016)
Tumour necrosis factor inhibitors used in the treatment of rheumatoid arthritis: Evidence of safety, efficacy and health implication.
In:
Biologics in Rheumatology: New Developments, Clinical Uses and Health Implication.
(pp. 199-228).
Nova Science Publishers: New York, NY, USA.
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Abstract
Rheumatoid arthritis (RA) is a systemic autoimmune condition characterised by inflammation and destruction of synovial joints. The pathogenesis of inflammation is underpinned by interaction and activation of immune cells, which release inflammatory cytokines such as tumour necrosis factor (TNF) and interleukins. These mechanisms of disease pathogenesis were targeted by specific drugs in the form of monoclonal antibodies (mAb) or soluble receptors. The advent of biological disease modifying therapies (bDMARDs) has revolutionised the management of RA. These agents dramatically reduce synovial inflammation, halt the progression of radiographic joint damage, and improve functional ability and health related quality of life outcomes. This has a positive impact on the socioeconomic burden of RA. This chapter reviews the pathogenesis of RA and evidence behind the use of TNF inhibitors licensed for RA treatment. We focus on clinical efficacy, safety profile and cost-effectiveness of infliximab, etanercept, adalimumab, certolizumab, golimumab. Additionally, we discuss national and international recommendations for the clinical use of TNF inhibitors, with further consideration of the financial implications. Examples of clinical randomised controlled trials (RCTs), which have proven the efficacy of different TNF inhibitors in RA are also included in this chapter. The use of TNF inhibitor biosimilars will be discussed in chapter 11.
| Type: | Book chapter |
|---|---|
| Title: | Tumour necrosis factor inhibitors used in the treatment of rheumatoid arthritis: Evidence of safety, efficacy and health implication |
| ISBN-13: | 9781634852746 |
| Open access status: | An open access version is available from UCL Discovery |
| Publisher version: | https://novapublishers.com/shop/biologics-in-rheum... |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher's terms and conditions. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Inflammation |
| URI: | https://discovery.ucl.ac.uk/id/eprint/1538872 |
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