Clinical use of anti-TNF therapy and increased risk of infections

• Published in: Drug, healthcare and patient safety healthcare and patient safety, 2013-01, Vol.5 (default), p.79-99
• Main Authors: Ali, Tauseef, Kaitha, Sindhu, Mahmood, Sultan, Ftesi, Abdul, Stone, Jordan, Bronze, Michael S
• Format: Article
• Language: English
• Subjects: Complications and side effects; Dosage and administration; Infections; Opportunistic infections; Review; Risk factors; Tumor necrosis factor inhibitors
• ISSN: 1179-1365; 1179-1365
• DOI: 10.2147/dhps.s28801

Biologics such as antitumor necrosis factor (anti-TNF) drugs have emerged as important agents in the treatment of many chronic inflammatory diseases, especially in cases refractory to conventional treatment modalities. However, opportunistic infections have become a major safety concern in patients on anti-TNF therapy, and physicians who utilize these agents must understand the increased risks of infection. A literature review of the published data on the risk of bacterial, viral, fungal, and parasitic infections associated with anti-TNF therapy was performed and the clinical presentation, diagnostic tests, management, and prevention of opportunistic infections in patients receiving anti-TNF therapy were reviewed. Awareness of the therapeutic potential and associated adverse events is necessary for maximizing therapeutic benefits while minimizing adverse effects from anti-TNF treatments. Patients should be adequately vaccinated when possible and closely monitored for early signs of infection. When serious infections occur, withdrawal of anti-TNF therapy may be necessary until the infection has been identified and properly treated.