Tuberculosis and Biologic Therapies: Anti-Tumor Necrosis Factor-α and Beyond

Mark S Godfrey; Lloyd N Friedman

doi:10.1016/j.ccm.2019.07.003

Tuberculosis and Biologic Therapies: Anti-Tumor Necrosis Factor-α and Beyond

Clin Chest Med. 2019 Dec;40(4):721-739. doi: 10.1016/j.ccm.2019.07.003.

Authors

Mark S Godfrey¹, Lloyd N Friedman²

Affiliations

¹ Section of Pulmonary, Critical Care, and Sleep Medicine, Yale University School of Medicine, 300 Cedar Street, TAC S425, PO Box 208057, New Haven, CT 06520, USA.
² Section of Pulmonary, Critical Care, and Sleep Medicine, Yale University School of Medicine, 300 Cedar Street, TAC S425, PO Box 208057, New Haven, CT 06520, USA. Electronic address: Lloyd.friedman@yale.edu.

PMID: 31731980
DOI: 10.1016/j.ccm.2019.07.003

Abstract

Biologic drugs have revolutionized the treatment of certain hematologic, autoimmune, and malignant diseases, but they may place patients at risk for reactivation or acquisition of tuberculosis. This risk is highest with the tumor necrosis factor-alpha (TNF-α) inhibitors. Amongst this class of drugs, the monoclonal antibodies (infliximab, adalimumab, golimumab) and antibody fragment (certolizumab) carry an increased risk compared to the soluble receptor fusion molecule, etanercept. Treatment of latent TB is critical to decrease the risk of reactivation. Data continues to emerge regarding tuberculosis risk associated with novel biologics targeting cytokines involved in tuberculosis control.

Keywords: Antibodies; Biological therapy; Monoclonal; Opportunistic infection; Tuberculosis; Tumor necrosis factor-alpha.

Publication types

Review

MeSH terms

Biological Therapy / methods*
Humans
Tuberculosis / therapy*
Tumor Necrosis Factor-alpha / antagonists & inhibitors*
Tumor Necrosis Factor-alpha / therapeutic use

Substances

Tumor Necrosis Factor-alpha