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

Tauseef Ali,1,2 Sindhu Kaitha,2 Sultan Mahmood,2 Abdul Ftesi,3 Jordan Stone,2 Michael S Bronze21OU Physicians Center for Inflammatory Bowel Disease, University of Oklahoma Health Sciences Center, 2Department of Internal Medicine, University of Oklahoma Health Sciences Center, 3Integris Baptist Hospital, Oklahoma City, Oklahoma, USAAbstract: 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.Keywords: anti-TNF therapy, infections