Indications
Pharmacology
Metabolism
Administration
Dose Adjustment
General Adverse Effects of Anti-Tumor Necrosis Factor-α (Anti-TNFα) Therapy
Dermatologic Adverse Effects
Erythema Multiforme (see Erythema Multiforme, [[Erythema Multiforme]])
Infectious Adverse Effects
- Aspergillus (see Aspergillus, [[Aspergillus]])
- Invasive Pulmonary Aspergillosis (see Aspergillus, [[Aspergillus]])
- Blastomyces (see Blastomycosis, [[Blastomycosis]]): case report of 3 cases
- Candida (see Candida, [[Candida]])
- Candida Esophagitis
- Candidemia
- Oropharyngeal Thrush
- Coccidioides Immitis (see Coccidioidomycosis, [[Coccidioidomycosis]])
- Cryptococcus (see Cryptococcosis, [[Cryptococcosis]]): 28 published cases
- Histoplasma (see Histoplasmosis, [[Histoplasmosis]])
- Legionella (see Legionellosis, [[Legionellosis]]): case series of 10 patients
- Listeriosis (see Listeriosis, [[Listeriosis]]): case series of 15 patients
- Mycobacterium Tuberculosis (see Tuberculosis, [[Tuberculosis]])
- Pneumocystis Jirovecii (see Pneumocystis Jirovecii, [[Pneumocystis Jirovecii]])
- Strongyloides (see Strongyloidiasis, [[Strongyloidiasis]]): 1 case report
- Viral Upper Respiratory Infections (however, there is no increased risk of viral pneumonias)
Pulmonary Adverse Effects
Accelerated Progression of Rheumatoid Lung Nodules (see Rheumatoid Arthritis, [[Rheumatoid Arthritis]])
- Epidemiology
- Etanercept (Enbrel) (see Etanercept, [[Etanercept]]): may accelerate progression of rheumatoid lung nodules
Acute Respiratory Distress Syndrome (ARDS) (see Acute Respiratory Distress Syndrome, [[Acute Respiratory Distress Syndrome]])
- Epidemiology
- Infliximab (Remicade) (see Infliximab, [[Infliximab]])
Granulomatous Lung Disease (see Granulomatous Lung Disease, [[Granulomatous Lung Disease]])
- Epidemiology
- Etanercept (Enbrel) (see Etanercept, [[Etanercept]]): can cause a pneumonitis with non-necrotizing granulomas and lymphohistiocytic infiltrates
- Infliximab (Remicade) (see Infliximab, [[Infliximab]]): can cause a pulmonary “bronchiocentric allergic granulomatosis” (observed in a patient with ankylosing spondylitis)
Interstitial Lung Disease (ILD) (see Interstitial Lung Disease, [[Interstitial Lung Disease]])
- Epidemiology
- Etanercept (Enbrel) (see Etanercept, [[Etanercept]]): may worsen pre-existing RA-associated interstitial lung disease
- Infliximab (Remicade) (see Infliximab, [[Infliximab]])
- May worsen pre-existing RA-associated interstitial lung disease
- Addition of infliximab can precipitate methotrexate pneumonitis (see Methotrexate, [[Methotrexate]])
- Adalimumab (Humira) (see Adalimumab, [[Adalimumab]]): interstitial lung disease has been reported
Pulmonary Infiltrates with Eosinophilia (see Drug-Induced Pulmonary Eosinophilia, [[Drug-Induced Pulmonary Eosinophilia]])
- Epidemiology
- Infliximab (Remicade) (see Infliximab, [[Infliximab]])
Renal Adverse Effetcs
Acute Interstitial Nephritis (see Acute Interstitial Nephritis, [[Acute Interstitial Nephritis]])
- Epidemiology: associated with etanercept
Rheumatologic Adverse Effects
Accelerated Progression of Rheumatoid Lung Nodules (see Rheumatoid Arthritis, [[Rheumatoid Arthritis]])
- Epidemiology
- Etanercept (Enbrel) (see Etanercept, [[Etanercept]]): may accelerate progression of rheumatoid lung nodules
Drug-Induced Systemic Lupus Erythematosus (SLE) (see Systemic Lupus Erythematosus, [[Systemic Lupus Erythematosus]])
- Epidemiology
- Adalimumab (Humira) (see Adalimumab, [[Adalimumab]])
- Etanercept (Enbrel) (see Etanercept, [[Etanercept]])
- Infliximab (Remicade) (see Infliximab, [[Infliximab]])
References
- Mice lacking the tumour necrosis factor receptor 1 are resistant to TNF-mediated toxicity but highly susceptible to infection by Listeria monocytogenes. Nature 1993; 364:798-802
- Etanercept therapy in rheumatoid arthritis: a randomized, controlled trial. Ann Intern Med 1999; 130:478-486
- Infliximab (chimeric anti-tumor necrosis factor-alpha monoclonal antibody) versus placebo in rheumatoid arthritis patients receiving concomitant methotrexate: a randomised phase III trial. Lancet 1999; 354:1932-1939
- Tumor necrosis factor alpha antibody (infliximab) therapy profoundly downregulates the inflammation in Crohn’s ileocolitis. Gastroenterology 1999; 116:22-28
- Tuberculosis associated with infliximab, a tumor necrosis factor alpha-neutralizing agent. N Engl J Med 2001; 345:1098-1104
- Cell-mediated immunity to Histoplasma capsulatum. Semin Respir Infect 2001; 16:102-108
- Life-threatening histoplasmosis complicating immunotherapy with tumor necrosis factor-alpha
antagonists infliximab and etanercept. Arthritis Rheum 2002; 46:2565-2570
- Methotrexate pneumonitis after initiation of infliximab therapy for rheumatoid arthritis. Arthritis Rheum 2002; 47:670-671
- Delayed hypersensitivity reaction and acute respiratory distress syndrome following infliximab infusion. Inflamm Bowel Dis 2002; 8:186-191 [MEDLINE]
- Accelerated nodulosis and vasculitis following etanercept therapy for rheumatoid arthritis. Arthritis Rheum 2002; 47:445-449 [MEDLINE]
- Methotrexate pneumonitis after initiation of infliximab therapy for rheumatoid arthritis. Arthritis Rheum 2002; 47:670-671
- Treatment of active ankylosing spondylitis with infliximab: a randomised controlled multicentre trial. Lancet 2002; 359:1187-1193
- Frequency of infection in patients with rheumatoid arthritis compared with controls: a population-based study. Arthritis Rheum 2002; 46:2287-2293
- Accelerated nodulosis and vasculitis following etanercept therapy for rheumatoid arthritis. Arthritis Rheum 2002; 47:445-449
- Treatment of active ankylosing spondylitis with infliximab: a randomised controlled multicentre trial. Lancet 2002; 359:1187-1193
- Delayed hypersensitivity reaction and acute respiratory distress syndrome following infliximab infusion. Inflamm Bowel Dis 2002; 8:186-191
- Anti-tumour necrosis factor agents and tuberculosis risk: mechanisms of action and clinical management. Lancet Infect Dis 2003; 3:148-155
- Tuberculosis in the cytokine era: what rheumatologists need to know. Arthritis Rheum 2003; 48:2085-2091
- Histoplasmosis after treatment with anti-tumor necrosis factor-alpha therapy. Am J Respir Crit Care Med 2003; 167:1279-1282
- Granulomatous infections and tumor necrosis factor-antagonist therapies. Abstract (# THU0209) presented at: Proceedings of the Annual European Congress of Rheumatology European League Against Rheumatism; June 18-21, 2003; Lisbon, Portugal.
- Listeria monocytogenes infection as a complication of treatment with tumor necrosis factor alpha- neutralizing agents. Arthritis Rheum 2003; 48:319-324
- Increased risk of coccidioidomycosis in patients treated with tumor necrosis factor-alpha antagonists. Arthritis Rheum 2004; 50:1959-1966
- Tumor necrosis factor-alpha blockade for the treatment of acute GVHD. Blood 2004; 104:649-654
- Fatal exacerbation of rheumatoid arthritis associated fibrosing alveolitis in patients given infliximab. BMJ 2004; 329:1266
- New drugs for rheumatoid arthritis. N Engl J Med 2004; 350:2167-2179
- Granulomatous infectious diseases associated with tumor necrosis factor antagonists. Clin Infect Dis 2004; 38:1261-1265
- Effects of infliximab on apoptosis and reverse signaling of monocytes from healthy individuals and patients with Crohn’s disease. Inflamm Bowel Dis 2004; 10:801-810
- Pneumocystis carinii pneumonia with oral candidiasis after infliximab therapy for Crohn’s disease. Dig Dis Sci 2004; 1458- 1460
- Fatal exacerbation of rheumatoid arthritis associated fibrosing alveolitis in patients given infliximab. BMJ 2004; 329:1266
- Interstitial pneumonitis associated with infliximab therapy. J Rheumatol 2006; 33:1189-1193
- Pulmonary lymphohistiocytic reactions temporally related to etanercept therapy. Mod Pathol 2005; 18:651-655
- Clinical pharmacokinetics of TNF antagonists: how do they differ? Semin Arthritis Rheum 2005; 34:12-18
- Tuberculosis associated with therapy against tumor necrosis factor-alpha. Arthritis Rheum 2005; 52:2968- 2974
- Infections associated with tumor necrosis factor-alpha antagonists. Medicine 2005; 84:291-302
- Pulmonary lymphohistiocytic reactions temporally related to etanercept therapy. Mod Pathol 2005; 18:651-655
- Pulmonary complications of infliximab therapy in patients with rheumatoid arthritis. J Rheumatol 2006; 33:622-628
- Tumor necrosis factor blockers: differential effects on mycobacterial immunity. J Infect Dis 2006; 194:486-492
- Safety analyses of adalimumab (HUMIRA) in global clinical trials and US postmarketing surveillance of patients with rheumatoid arthritis. Ann Rheum Dis 2006; 65:889-894
- Emergence of Legionella pneumophila pneumonia in patients receiving tumor necrosis factor- alpha antagonists. Clin Infect Dis 2006; 43:e95-e100
- Pulmonary complications of infliximab therapy in patients with rheumatoid arthritis. J Rheumatol 2006; 33:622-628
- Interstitial pneumonitis associated with infliximab therapy. J Rheumatol 2006; 33:1189-1193
- Development of active tuberculosis following initiation of infliximab despite appropriate prophylaxis. Rheumatology (Oxford) 2007; 46:887-888
- Pneumocystis jiroveci (carinii) pneumonia after infliximab therapy: a review of 84 cases. Dig Dis Sci 2007; 52:1481-1484
- Pneumocystis carinii pneumonia in a patient on etanercept for psoriatic arthritis. Ir J Med Sci 2007; 176:309-311
- Pneumocystis carinii pneumonia in a rheumatoid arthritis patient treated with adalimumab. Scand J Infect Dis 2007; 39:475-478
- Strongyloides stercoralis hyperinfection in a patient with rheumatoid arthritis after anti-TNF-alpha therapy. J Clin Rheumatol 2007; 13:150-152
- Fungal infections complicating tumor necrosis factor-alpha blockade therapy. Mayo Clin Proc 2008; 83:181-194
- Acute interstitial nephritis associated with etanercept. Rheumatol Int 2008;28:1283-4
- Rheumatology (Oxford). 2009 Jul;48(7):716-20. Epub 2009 May 4
- Adalimumab-induced interstitial pneumonia with an improvement of pre-existing rheumatoid arthritis-associated lung involvement. Intern Med. 2011;50(7):749-51