Table 2.

TNF inhibitors used in RA

TNF inhibitor	Molecular structure	Administration	Randomized controlled trials (double-blind, unless otherwise stated)
		Dose Route Frequency
Infliximab	Chimeric monoclonal antibody to TNF; human and mouse components.	3 or 5 mg/kg Intravenous At 0, 2, and 6 weeks then every 2 months Concomitant MTX is necessary to decrease immunogenicity.	ATTRACT11,12 Early RA and MTX-naïve: ASPIRE13 Early RA: BeSt14 (single-blind)
Adalimumab	Fully human monoclonal antibody to TNF.	40 mg Subcutaneous Every 2 weeks	ARMADA15 van der Putte et al16 Early RA and MTX-naïve: PREMIER17 PROWD18
Etanercept	Fusion protein of the soluble TNF receptor, linked to the constant fragment (Fc) of immunoglobulin.	50 mg Subcutaneous Every week (or 25 mg twice weekly)	Weinblatt et al19 Moreland et al20 TEMPO21 Early RA and MTX-naïve: COMET22 Bathon et al23
Certolizumab	Antigen-binding fragment (Fab) of human anti-TNF antibody bound to polyethylene glycol, as opposed to the Fc fragment present in other monoclonal antibodies and anti-TNF drugs. Developed with lack of the Fc fragment, with the intention of increasing its half-life and reducing immunogenicity.	400 mg Subcutaneous At 0, 2, and 4 weeks then every 4 weeks (or 200 mg every 2 weeks)	RAPID 124 RAPID 225 FAST4WARD26
Golimumab	Fully human monoclonal antibody to TNF.	50 mg Subcutaneous Every 4 weeks	GO-FORWARD27 Early RA and MTX-naïve: GO-BEFORE28 Previous Anti-TNF Treatment: GO-AFTER29