Tumor necrosis factor (TNF) inhibitors are a class of biologic medications used to manage various inflammatory conditions. Derived from living organisms, these therapies interfere with specific immune system components. They have become a significant option for individuals experiencing chronic inflammation.
The Role of TNF in the Body and Disease
Tumor Necrosis Factor (TNF) is a protein and signaling molecule within the immune system. Its normal function involves orchestrating inflammatory responses and helping the body fight infections. When the body encounters threats like bacteria or viruses, TNF is released to initiate a protective inflammatory cascade, directing immune cells to the affected area.
However, in certain conditions, the body produces too much TNF, or its activity becomes unregulated. This overproduction leads to persistent, uncontrolled inflammation, damaging healthy tissues. This dysregulation is a hallmark of many chronic inflammatory and autoimmune diseases, where the immune system mistakenly attacks its own body.
How TNF Inhibitors Work
TNF inhibitors block the activity of tumor necrosis factor. These medications consist of laboratory-made antibodies or fusion proteins designed to bind to TNF. By binding, they prevent TNF from interacting with cell receptors, effectively neutralizing its inflammatory signals.
This targeted action reduces widespread inflammation that contributes to chronic pain and tissue damage. Interrupting the TNF pathway can slow the progression of diseases driven by excessive inflammation.
Conditions Treated by TNF Inhibitors
TNF inhibitors are prescribed for a range of autoimmune and inflammatory conditions where excessive TNF activity contributes to disease progression. Rheumatoid arthritis, a condition causing joint inflammation and damage, benefits from TNF inhibition by reducing swelling and pain. Psoriatic arthritis, which affects both joints and skin, also sees improvement in both aspects.
Ankylosing spondylitis, characterized by inflammation of the spine and large joints, responds to these medications by decreasing spinal stiffness. For inflammatory bowel diseases such as Crohn’s disease and ulcerative colitis, TNF inhibitors help to reduce gut inflammation and improve symptoms like abdominal pain and diarrhea. Plaque psoriasis, a skin condition marked by red, scaly patches, also shows significant clearing with TNF inhibitor therapy.
Administering and Monitoring TNF Inhibitors
TNF inhibitors are administered either through subcutaneous injections or intravenous infusions. Subcutaneous injections are given under the skin, often in the thigh or abdomen, and can be self-administered at home after initial training. These injections are typically given weekly, every other week, or monthly, depending on the specific medication.
Intravenous infusions, on the other hand, are administered by a healthcare professional in a clinic or hospital setting, usually every 4 to 8 weeks, and can take a few hours. Medical supervision is important throughout treatment, involving routine blood tests to monitor liver and kidney function. Before starting treatment, patients are screened for latent infections like tuberculosis and hepatitis B to prevent reactivation, as TNF inhibitors can increase infection risk.
Potential Side Effects
While beneficial, TNF inhibitors carry potential side effects that patients should discuss with their healthcare provider. Common reactions include mild injection site reactions, such as redness, swelling, or pain, which usually subside within a week. Patients may also experience a higher frequency of mild infections, like common colds or sinus infections.
More serious side effects, though less frequent, warrant careful consideration. There is an increased risk of severe infections, including tuberculosis and serious fungal infections, due to the immune-suppressing effects of the medication. TNF inhibitors can also exacerbate existing heart failure, and in rare instances, have been linked to neurological problems or certain types of skin cancers.