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"Etanercept or adalimumab" refers to the anti-tumor necrosis factor (TNF) biologic agents used as the comparator arm in the ORBIT trial (Rituximab vs Anti-TNF in Biologic-Naive Rheumatoid Arthritis), sponsored by the University of Glasgow. This arm represents the standard-of-care biologic therapy for biologic-naive patients with active, seropositive rheumatoid arthritis who have failed conventional synthetic disease-modifying antirheumatic drugs (DMARDs). Etanercept (Enbrel) is a dimeric fusion protein consisting of the extracellular ligand-binding portion of the human 75 kDa (p75) tumor necrosis factor receptor (TNFR) fused to the Fc portion of human IgG1; it inhibits both TNF-α and TNF-β. Adalimumab (Humira) is a fully human IgG1 monoclonal antibody that selectively targets and neutralizes TNF-α. Both agents are administered via subcutaneous injection and are approved for the treatment of several inflammatory conditions, including rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis.
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