Incidence and nature of infectious disease in patients treated with anti-TNF agents

Autoimmun Rev. 2009 Dec;9(2):67-81. doi: 10.1016/j.autrev.2009.08.006. Epub 2009 Aug 27.


Tumor necrosis factor alpha (TNF-alpha) inhibitors offer a targeted therapeutic strategy that contrasts with the nonspecific immunosuppressive agents traditionally used to treat most inflammatory diseases. These biologic agents have had a significant impact in ameliorating the signs and symptoms of inflammatory rheumatoid disease and improving patient function. From the onset of clinical trials, a central concern of cytokine blockade has been a potential increase in susceptibility to infections. Not surprisingly, a variety of infections have been reported in association with the use of TNF-alpha inhibitor agents. In particular, there is evidence suggesting an increased rate of granulomatous infections in patients treated with monoclonal TNF-alpha inhibitors. This review provides the incidence and nature of infections in patients treated with TNF-alpha inhibitor agents and reminds the clinician of the required vigilance in monitoring patients.

Publication types

  • Review

MeSH terms

  • Animals
  • Antibodies, Monoclonal / administration & dosage
  • Antibodies, Monoclonal / adverse effects
  • Autoimmune Diseases / immunology
  • Autoimmune Diseases / therapy*
  • Communicable Diseases / diagnosis
  • Communicable Diseases / epidemiology
  • Communicable Diseases / etiology*
  • Communicable Diseases / immunology
  • Humans
  • Immunosuppression Therapy / adverse effects
  • Incidence
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors*
  • Tumor Necrosis Factor-alpha / immunology


  • Antibodies, Monoclonal
  • Tumor Necrosis Factor-alpha