Table 1.

Type, mechanism of action and FDA- and EMA-approved indications of currently available anti-TNF-α agents (modified from ref. [2]).

Agent	Type	Target	Mechanism of action	Mode of administrationa	Approved indications
Infliximab (Remicade® and biosimilars)	Human-mouse chimeric IgG1 monoclonal antibody	mTNF-α, sTNF-α	Neutralization, apoptosis, reverse signaling, ADCC, CDC	IV injection every 6-8 weeks	IBD (CD and UC), RA, AS, PsA,plaque psoriasis
Etanercept (Enbrel®)	Fusion protein of the soluble TNFR2/p75 receptor and human IgG1 antibody (hinge, CH2 and CH3 domains of the Fc region)	mTNF-α, sTNF-α, TNF-β	Competitive inhibition, ADCC, CDC (weaker)	SC injection once or twice weekly	RA, AS, JIA, PsA, plaque psoriasis
Adalimumab (Humira®)	Fully human IgG1 monoclonal antibody	mTNF-α, sTNF-α	Neutralization, apoptosis, reverse signaling, ADCC, CDC	SC injection every 2 weeks	IBD (CD and UC), RA, AS, JIA, PsA, plaque psoriasis, hidradenitis, suppurativa, uveitis
Golimumab (Simponi®)	Fully human IgG1 monoclonal antibody	mTNF-α, sTNF-α	Neutralization, apoptosis, reverse signaling, ADCC, CDC	SC injection every 4 weeks	UC, RA, AS, JIA, PsA
Certolizumab pegol (Cimzia®)	PEGylated Fab’ fragment of humanized IgG4 monoclonal antibody	mTNF-α, sTNF-α	Neutralization, reverse signaling	SC injection every 2-4 weeks	CD (only FDA), RA, AS, PsA, plaque psoriasis (only EMA)

ADCC: antibody-dependent cell-mediated cytotoxicity; AS: ankylosing spondylitis; CD: Crohn’s disease; CDC: complement-dependent cytotoxicity; EMA: European Medicines Agency; FDA: Food and Drug Administration; IBD: inflammatory bowel disease; IV: intravenous; JIA: juvenile idiopathic arthritis; PS: plaque psoriasis; PsA: psoriatic arthritis; RA: rheumatoid arthritis; SC: subcutaneous; sTNF-α: soluble tumor necrosis factor α;mTNF- α: membrane-bound tumor necrosis factor α; UC: ulcerative colitis. aMaintenance doses once clinical response has been observed; initial doses vary according to the indication.