Anti-TNF-α biotherapies: perspectives for evidence-based personalized medicine

This article discusses the rationale behind recommending immunopharmacological guidance of long-term therapies with genetically engineered anti-TNF-alpha immunoglobulin constructs. Arguments why therapeutic decision-making should not rely on clinical outcome alone are presented. Central to this is that the use of theranostics (i.e., monitoring circulating levels of functional anti-TNF-alpha drugs and antidrug antibodies) would markedly improve treatment because therapies can be tailored to individual patients and provide more effective and economical long-term therapies with minimal risk of side effects. Large-scale immunopharmacological knowledge of how patients 'handle' TNF-alpha biopharmaceuticals would also help industry develop more effective and safer TNF-alpha inhibitors.