From dependency to discovery

An independent analysis of how the success of TNF-α inhibition shaped three decades of pharmaceutical investment in immune-mediated diseases. The paper examines the commercial legacy of the TNF-α cascade, the resulting concentration of development around a limited set of validated targets, the persistence of primary non-response in a substantial minority of patients, and the research directions left underexplored. It concludes with a discussion of the next frontier in immune-mediated disease. This is a non-peer-reviewed independent analysis.