Tumor necrosis factor-alpha inhibitors and mycobacterial infections
- Robert S Wallis, MD
Robert S Wallis, MD
- Chief Science Officer, Aurum Institute
- Adjunct Professor
- Case Western Reserve University and Rutgers University
- Section Editor
- C Fordham von Reyn, MD
C Fordham von Reyn, MD
- Section Editor — Tuberculosis; Nontuberculous Mycobacterial Infections
- Professor of Medicine
- Geisel School of Medicine at Dartmouth
- Deputy Editors
- Anna R Thorner, MD
Anna R Thorner, MD
- Co-Director, Editorial Projects — UpToDate
- Deputy Editor — Infectious Diseases
- Assistant Professor of Medicine, Part-time
- Harvard Medical School
- Paul L Romain, MD
Paul L Romain, MD
- Deputy Editor — Rheumatology
- Assistant Professor of Medicine, Part-time
- Harvard Medical School
Inhibitors of tumor necrosis factor (TNF)-alpha represent important treatment advances in a number of inflammatory conditions, including rheumatoid arthritis, the seronegative spondyloarthropathies, and inflammatory bowel disease. TNF-alpha inhibitors offer a targeted strategy that contrasts with the nonspecific immunosuppressive agents traditionally used to treat most inflammatory diseases.
However, multiple complications and adverse effects of targeted TNF-alpha inhibition have been identified. These include:
●Mycobacterial infection, particularly tuberculosis
●Other infections (bacterial, viral, and fungal)
●Injection site reactions
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- TNF-ALPHA INHIBITORS
- TNF-ALPHA AND HOST DEFENSES
- RISK OF TB
- AERS database
- Spain and Portugal
- United Kingdom
- Other studies
- Influence of underlying RA
- Study limitations
- RISK WITH DIFFERENT AGENTS
- Biological basis of differential risks
- TIME TO ONSET
- LATENT INFECTION VERSUS NEW INFECTION
- CLINICAL FEATURES
- SCREENING AND PREVENTION
- Screening following BCG administration
- Latent TB infection
- Active TB
- - Disease worsening during TB treatment
- RISK OF NONTUBERCULOUS MYCOBACTERIAL INFECTIONS
- SUMMARY AND RECOMMENDATIONS