All of the following are tumor necrosis factor blocking agents, except –
**Core Concept**
Tumor necrosis factor (TNF) blocking agents are a class of medications used to treat autoimmune diseases by inhibiting the action of TNF, a pro-inflammatory cytokine involved in systemic inflammation and one of the cytokines that make up the acute phase reaction, which is part of the initial immune response. These agents are used to treat conditions such as rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis.
**Why the Correct Answer is Right**
TNF blocking agents work by binding to TNF and preventing it from interacting with its receptors on the surface of cells. This leads to a decrease in inflammation and a reduction in the severity of symptoms associated with autoimmune diseases. Examples of TNF blocking agents include etanercept, adalimumab, and infliximab. These drugs are administered via injection and have revolutionized the treatment of autoimmune diseases.
**Why Each Wrong Option is Incorrect**
**Option A:** Etanercept is a TNF blocking agent, so this option is incorrect.
**Option B:** Adalimumab is a TNF blocking agent, so this option is incorrect.
**Option C:** Infliximab is a TNF blocking agent, so this option is incorrect.
**Option D:** Tocilizumab is an interleukin-6 (IL-6) receptor antagonist, not a TNF blocking agent, making it the correct answer.
**Clinical Pearl / High-Yield Fact**
TNF blocking agents can increase the risk of infections, including reactivation of latent tuberculosis. Patients receiving these medications should be screened for latent TB before starting treatment.
**Correct Answer:** D. Tocilizumab.