Medications known as TNF-alpha blockers are used in adults and children with various types of autoimmune or inflammatory diseases. According to the U.S. Food and Drug Administration, these high-cost drugs are approved for use to treat conditions like juvenile rheumatoid arthritis, Crohn's disease and inflammatory bowel disease. The medications work by blocking a protein known as tumor necrosis factor (TNF) that can cause inflammation that harms body tissues. The FDA has issued warnings regarding an increased risk of leukemia in patients who are treated with TNF inhibitors.
Enbrel
Enbrel, or etanercept, was the first TNF blocker approved by the FDA. It was made by Amgen and is marketed by Pfizer. According to the prescribing information, Enbrel is approved to treat rheumatoid arthritis, juvenile idiopathic arthritis, psoriasis, arthritis associated with psoriasis and a condition known as ankylosing spondylitis. Patients give themselves weekly doses of Enbrel by injection under the skin. Side effects include infections, seizures, heart failure and allergic reactions.
Remicade
Remicade is the brand name of infliximab, another biologic TNF alpha blocker. It is made by Centocor and treats conditions similar to Enbrel. Remicade is not approved for juvenile idiopathic arthritis, but is also indicated for Crohn's disease and ulcerative colitis. Side effects are the same as those experienced by patients using Enbrel and include infections, seizures, heart failure and allergic reactions. Remicade is given by infusion through a vein, so it must be dosed in a hospital or in a healthcare provider's office.
Humira
Adalimumab is marketed by Abbott Labs under the brand name, Humira. According to the prescribing information, it approved for use by the FDA for similar conditions as both Enbrel and Remicade. Side effects of Humira are also the same as those reported in patients using Enbrel and Remicade and include infections, seizures, heart failure and allergic reactions. Abbott offers a patient assistance program to help low-income patients pay for their medication. Humira is given as an injection under the skin every other week.
Cimzia
Cimzia is the brand name for certolizumab pegol and is made by UCB. It is currently approved only for rheumatoid arthritis and Crohn's disease. Cimzia is an injectable medication with two dosing options. The medication is given under the skin every two to four weeks. This can be performed in a doctor's office or at home by the patient with a specially-designed syringe. Cimzia has been associated with similar side effects as other TNF blockers, but also has an increased risk for patients developing severe fungal infections such as histoplasmosis.
Simponi
Simponi has the generic name, golimumab, and is also made by Centocor Ortho Biotech, the manufacturer of Remicade. According to the prescribing information, it is similar to other TNF inhibitors, but is designed to be given only once monthly. Simponi carries the same side effect warnings as other TNF blockers, but has specifically been associated with infections, cancers and worsening psoriasis. It is approved for rheumatoid arthritis, arthritis associated with psoriasis and ankylosing spondylitis.
