Role of biological agents in immune-mediated inflammatory diseases

South Med J. 2005 Feb;98(2):192-204. doi: 10.1097/01.SMJ.0000153119.37032.8B.


A new era in the treatment of immune-mediated inflammatory disorders has begun with the clinical availability of anticytokine therapy. Biological agents that are currently available include 3 agents that decrease the activity of tumor necrosis factor-alpha (infliximab, adalimumab, etanercept) and an interleukin-1 receptor antagonist (anakinra), with many more in development. Those extraordinarily effective medications are an important addition to our therapeutic armamentarium, and, although originally developed for rheumatoid arthritis and Crohn disease, have been found to be efficacious in the treatment of seronegative spondyloarthropathies (psoriatic arthritis, ankylosing spondylitis) and juvenile rheumatoid arthritis. Their role is currently being defined in other autoimmune disorders such as uveitis, sarcoidosis, interstitial lung disease, vasculitis, inflammatory myopathies, graft-versus-host disease, and Sjögren syndrome.

Publication types

  • Review

MeSH terms

  • Adalimumab
  • Antibodies, Monoclonal / therapeutic use
  • Antibodies, Monoclonal, Humanized
  • Antirheumatic Agents / therapeutic use
  • Arthritis, Rheumatoid / drug therapy*
  • Autoimmune Diseases / drug therapy*
  • Etanercept
  • Humans
  • Immunoglobulin G / therapeutic use
  • Immunologic Factors / therapeutic use*
  • Inflammation / drug therapy*
  • Infliximab
  • Interleukin 1 Receptor Antagonist Protein
  • Interleukin-1 / physiology
  • Interleukin-1 / therapeutic use
  • Receptors, Tumor Necrosis Factor / therapeutic use
  • Sialoglycoproteins / therapeutic use
  • Tumor Necrosis Factor-alpha / physiology
  • Tumor Necrosis Factor-alpha / therapeutic use


  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Antirheumatic Agents
  • IL1RN protein, human
  • Immunoglobulin G
  • Immunologic Factors
  • Interleukin 1 Receptor Antagonist Protein
  • Interleukin-1
  • Receptors, Tumor Necrosis Factor
  • Sialoglycoproteins
  • Tumor Necrosis Factor-alpha
  • Infliximab
  • Adalimumab
  • Etanercept