Anti-TNF-alpha in 2002 : adverse events, new indications other than rheumatoid arthritis and spondylarthropathies.

TNF Alpha blocking agents have been a major advance in the treatment of rheumatoid arthritis and spondylarthropathies. To date, the most common adverse events are reactions to infliximab infusions and reactivation of active tuberculosis with infliximab. Association of another immunosuppressive drug, such as methotrexate, decreases the first of these adverse events. We can predict than the new fully humanized anti-TNF antibodies will not have this disadvantage. Recommendations recently issued from a group gathering different French scientific societies should have an effect to decrease reactivation of tuberculosis.New indications of TNF blockers are emerging and are now being evaluated: primary Sjo¨gren’s syndrome, refractory systemic vasculitis, dermatopolymyositis, serious uveitis, Behc¸et disease, adult Still disease, AA inflammatory amyloidosis. As soon as a new indication seems appealing, it is very important to rapidly begin multicentre controlled studies. After ending the inclusions in a French multicentre double dummy controlled study in Sjo¨gren’s syndrome, the “Club Rhumatismes et Inflammation” (CRI) would like to initiate new multicentre studies in refractory systemic vasculitis, dermatopolymyositis, and AA inflammatory amyloidosis. [ABSTRACT FROM AUTHOR]