[Selection of one of the TNF blockers; infliximab and etanercept].

Infliximab and etanercept, both of which inhibit tumor necrosis factor (TNF), show almost an equal efficacy in reducing disease activity of rheumatoid arthritis and suppressing joints and bone destruction in the disease. Requiring a concomitant usage of methotrexate (MTX), infliximab, a chimeric antibody against TNF-alpha, blocks TNF-alpha and kills TNF-alpha -producing cells. Etanercept, on the other hands, is a soluble TNF receptor which blocks TNF-alpha as well as TNF-beta but does not affect cells producing TNF-alpha. MTX is not required on the etanercept administration because no neutralizing antibodies against etanercept are theoretically generated. The strategy selecting one of them for a patient should be based on the understanding differences and characteristics of the reagents.