The monoclonal antibodies against TNF (Remicade, Humira) appear to work much better for Crohn’s disease compared with Enbrel, a soluble receptor that binds TNF. All three drugs clear TNF from the circulation so why this is, is not completely understood. Some have postulated that the size of the drug molecule has an effect, with the monoclonal antibodies being much smaller and this able to penetrate the tissues better, In addition, there may be differnces between the drugs for the treatment of skin psoriasis as well.
About Alan Matsumoto, M.D.
Part-time Faculty, Division of Rheumatology
Johns Hopkins University