Over the last decade, the advent of biologic agents has greatly
revolutionized therapeutic medicine in the management of chronic
inflammatory diseases, such as rheumatoid arthritis, Crohn's disease,
and psoriasis. Elucidation of the complex web of cytokine network and
the roles of these cytokines in the pat- genesis of inflammatory
disorders provided one of the key catalysts for the advancement of
targeted biologic therapy in autoimmune and inflammatory diseases. TNF-?
is known to play a crucial role in the pathogenesis of many chronic
inflammatory diseases. Elevated levels of TNF-? have been demonstrated
in Crohn's disease, psoriasis, psoriatic arthritis, and rheumatoid
arthritis, sugge- ing a role for TNF-? in their pathogenesis. Although
TNF-? plays a critical role in the activation of innate and acquired
immune responses, the persistence of the immune response and
inappropriate production of TNF-? can produce pathological changes
resulting from chronic inflammation and tissue damage. The purpose of
this volume is to provide a comprehensive overview of the development,
pharmacology, efficacy, and safety of the currently available TNF-?
inhibitors - etanercept, infliximab, and adalimumab. The initial three
chapters of the volume provide a background on the field on TNF-? and
its inhibition. Chapter 1 provides an introduction to TNF and reviews
the pathophysiology of this cytokine. Chapter 2 then presents the h-
tory of the development of TNF inhibitors. The pharmacology of these
agents is reviewed in Chapter 3.
