The biologic response modifiers block an immune system protein called tumor necrosis factor, which acts as an inflammatory agent in some types of arthritis. By targeting this protein, TNF blockers can help reduce pain, morning stiffness and swollen joints. Some people experience side effects during or shortly after these drugs are injected, including chest pain, dizziness and difficulty breathing, as well as redness, itching and swelling at the injection site. Additional side effects of biologic response modifiers may include abdominal pain, headache, respiratory infections such as tuberculosis, and other infections. These medications also may increase your risk of demyelinating disorders, conditions that damage the protective covering (myelin sheath) that surrounds nerves in your brain and spinal cord.
TNF-alpha is one of the most important cytokines , through its entanglement in the cascade of inflammatory reactions. TNF blockers bind to TNF-alpha, rendering it inactive, and interfering with
inflammatory activity, ultimately decreasing joint damage.
What Is Tumor Necrosis Factor (TNF)?
Tumor Necrosis Factor or TNF, is a cytokine which is involved in the inflammatory process. Cytokines are chemical substances which deliver messages between cells in the body.TNF blocker drugs target the effects of tumor necrosis factor-alpha.
TNF blocker drugs include.
Enbrel (etanercept)
Enbrel (etanercept) is a biologic response modifier (recombinant human soluble tumor necrosis factor receptor fusion protein). Enbrel is genetically engineered to be like the receptors in the body which bind to tumor necrosis factor (TNF-alpha). Enbrel works by soaking up excess TNF before it can attach to natural receptors.TNF-alpha is a cytokine involved in the inflammatory process. Enbrel is given by self-injection under the skin once or twice a week. Many people learn to give their own injections or receive them from a family member who has received proper instruction. A kit is available from the manufacturer that makes drawing up the medicine and injecting it easier. Enbrel may cause irritation at the injection site, which is diminished by applying a cold pack to the injection site prior to injection. Enbrel's effect can also weaken the immune system.
Are There Special Concerns or Contraindications for Enbrel?
Enbrel is not recommended for pregnant or nursing women. Patients with serious infections should not be treated with Enbrel. People prone to infection or those with uncontrolled diabetes should avoid using Enbrel. Patients with conditions of the central nervous system should also avoid Enbrel.
Remicade (infliximab)
Remicade (infliximab) is a biologic response modifier, specifically a monoclonal antibody which binds to and blocks tumor necrosis factor alpha (TNF-alpha). Tumor necrosis factor (TNF) alpha is a cytokine involved in the inflammatory process.As with other biologics, treatments may weaken the body's ability to fight infection.
Are There Special Concerns or Contraindications for Remicade?
Remicade is contraindicated in pregnant or nursing women. Remicade should not be given to people with a history of serious infection or people with uncontrolled diabetes. Remicade should not be given to patients with with moderate to severe congestive heart faiure. Also, a tuberculin skin test must precede treatment with Remicade.
HUMIRA (adalimumab)
HUMIRA ("Human Monoclonal Antibody in Rheumatoid Arthritis"). Like infliximab and etanercept, adalimumab binds to TNFα, preventing it from activating TNF receptors. The drug is an injection that can be self-administered
Points to Remember About Humira:
- Tell your doctor if you have an active infection.
- Tell your doctor if you have been infected with Hepatitis B or are a carrier. Humira has been associated with re-activation of Hepatitis B.
- Tell your doctor if you have numbness, tingling, or have had multiple sclerosis or a central nervous system disorder.
- Tell your doctor if you have been treated for heart failure.
- Tell your doctor before receiving any vaccines or surgery.