Safety of Anti-TNF Therapies in Immune-Mediated Inflammatory Diseases: Focus on Infections and Malignancy

Drug Dev Res. 2015 Dec;76(8):419-27. doi: 10.1002/ddr.21285. Epub 2015 Oct 20.


Preclinical Research The efficacy of anti-TNF agents in the treatment of multiple immune-mediated inflammatory diseases (IMIDs) has increased their daily use. However, concerns remain regarding their long-term safety profile. Using a literature-based review of the infectious and malignant complications of anti-TNF biologics in IMIDs including psoriasis, Rheumatoid Arthritis, and inflammatory bowel disease, this review presents current evidence relative to the safety of anti-TNF agents in the context infections and malignancy in adults with IMIDs. Treatment with anti-TNF biologics is an effective treatment option with known risks that can be mitigated by appreciating the safety aspects and via a thorough screening and continuous monitoring of the patient.

Keywords: anti-TNFa therapies; immune-mediated inflammatory diseases; infection; inflammatory bowel disease; malignancy; psoriasis; rheumatoid arthritis; safety.

Publication types

  • Review

MeSH terms

  • Anti-Inflammatory Agents, Non-Steroidal / administration & dosage
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects*
  • Antibodies, Monoclonal / administration & dosage
  • Antibodies, Monoclonal / adverse effects*
  • Humans
  • Immune System Diseases / drug therapy*
  • Infections / chemically induced
  • Infections / etiology*
  • Infections / immunology
  • Inflammation / drug therapy*
  • Inflammatory Bowel Diseases / drug therapy
  • Neoplasms / chemically induced
  • Neoplasms / etiology*
  • Neoplasms / immunology
  • Opportunistic Infections / chemically induced
  • Opportunistic Infections / etiology
  • Opportunistic Infections / immunology
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors*


  • Anti-Inflammatory Agents, Non-Steroidal
  • Antibodies, Monoclonal
  • Tumor Necrosis Factor-alpha