Anti-tumor necrosis factor therapies in immune-mediated rheumatic diseases. Other observations from the clinic.

To date, over 2 million patients worldwide have been treated with anti-tumor necrosis factor (TNF) therapies, dramatically improving the treatment outcomes of immune-mediated inflammatory diseases (IMID). Observations from clinicians have identified some curious disconnects between clinical and radiographic outcomes, and the paradoxical occurrence of anti-TNF therapy-induced IMID such as psoriasis or reactivation of uveitis and Crohn's disease. These observations point to the need for a better understanding of the mechanisms underlying the ability of anti-TNF therapies to reduce inflammation and how this is linked to the pathogenesis of IMID.