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Current state of tumour necrosis factor α blockade in Wegener’s granulomatosis
  1. C Mukhtyar1,
  2. R Luqmani2
  1. 1Stoke Mandeville Hospital, Aylesbury, UK
  2. 2Nuffield Orthopaedic Centre and University of Oxford, Oxford, UK
  1. Correspondence to:
    Dr R Luqmani
    Rheumatology Department, Nuffield Orthopaedic Centre, Windmill Road, Oxford OX3 7LD, UK; raashid.luqmaninoc.anglox.nhs.uk

Abstract

Tumour necrosis factor α (TNFα) is likely to be involved in the pathogenesis of Wegener’s granulomatosis. This paper reviews published clinical trials of the anti-TNFα 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 development of novel approaches focusing on blockade of specific molecules including TNFα in the treatment of Wegener’s granulomatosis is awaited.

  • ANCA, antineutrophilic cytoplasmic antibody
  • BVAS, Birmingham Vasculitis Activity Score
  • IL, interleukin
  • MPO, myeloperoxidase
  • PR3, proteinase-3
  • Th, T helper
  • TNF, tumour necrosis factor
  • WGET, Wegener’s Granulomatosis Etanercept Trial
  • Wegener’s granulomatosis
  • tumor necrosis factor-alpha/antagonists and inhibitors
  • infliximab
  • TNFR-Fc fusion protein
  • neoplasms

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Footnotes

  • Competing interests: none declared