Current state of tumour necrosis factor {alpha} blockade

Tumour necrosis factor a (TNFa) is likely to be involved in the pathogenesis of Wegener’s granulomatosis. This paper reviews published clinical trials of the anti-TNFa agents etanercept and infliximab with regard to their efficacy and safety in the treatment of Wegener’s granulomatosis. On the basis of the high rate of adverse events, particularly an increased incidence of cancers, the use of etanercept in the management of Wegener’s granulomatosis is not justified. However, the potential role for infliximab or the as yet untested adalimumab cannot be discounted. The develop-ment of novel approaches focusing on blockade of specific molecules including TNFa in the treatment of Wegener’s granulomatosis is awaited. T umour necrosis factor a (TNFa) has been successfull