Comparative mechanisms of action for various anti-tumour necrosis factor (TNF) agents
| Agent | Description of biologic construction | Binds soluble TNF | Binds membrane bound TNF | Fixes complement | Mediates >ADC | Causes T cell apoptosis | Effective in unselected patients | Effective only in patients with elevated CRP |
|---|---|---|---|---|---|---|---|---|
| ADC, antibody dependent cytotoxicity; CRP, C reactive protein; PEG, polyethylene glycol. | ||||||||
| Infliximab | IgG1 chimeric monoclonal antibody | Yes | Yes | Yes | Yes | Yes | Yes | No |
| Etanercept | Fusion protein comprised of a human IgG1 Fc antibody fragment linked to two human soluble p75 TNF receptors | Yes | Yes | No | No | No | No | ? |
| Adalimumab | Fully human IgG1 monoclonal antibody to TNF | Yes | Yes | Yes | Yes | Yes | ? | ? |
| CDP870 | Humanised Fab fragment linked to PEG | Yes | Yes | No | No | ? | No | Yes |
| CDP571 | Humanised IgG4 monoclonal antibody | Yes | Yes | No | No | ? | No | Yes |
| Onercept | Fully human soluble p55 TNF receptor monomer that binds soluble and membrane bound TNF but does not fix complement | Yes | Yes | No | No | No | No | ? |