Tailoring Enbrel dosages

[Guest guest]

I recently posted this excellent essay, but it is worth repeating.

Following is part of an editorial entitled, " TNF-alpha Inhibition: The

Need for a Tumor Necrosis Factor Thermostat " from the journal Mayo

Clinic Proceedings:

" The pivotal role that TNF plays in the immune system

should make us concerned about degrees of inhibition.

All patients with RA are different; logically, the degree of

TNF inhibition that will be optimal to control disease may

vary from patient to patient. This may depend on simple

things, such as the patient's weight or drug clearance/

metabolism, but also on much more complicated things

like each patient's innate TNF production and balance of

TH1 and TH2 functions, the relative TNF role in each

patient's RA, and many other factors. Ideally, we would

learn to titrate our therapy to produce the amount of TNF

inhibition that controls the disease without crippling important

immune functions. In other words, a TNF thermostat

is needed that would allow the clinician to dial the

level of TNF inhibition desired to maximize the benefit

and minimize the toxic effects. With the central role that

TNF plays in our immune system, it is naive to believe

that complete blocking of TNF for long periods of time

will be without toxic effects. I believe that if we block

TNF well enough for long enough considerable problems

will occur. "

For the entire article, please see:

http://www.mayo.edu/proceedings/2001/jun/7606e2.pdf