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 Bronze2
1OU 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, USA
Abstract: 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
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