Infections in Patients with Rheumatic Diseases Treated with TNF Antagonists

TNF has a critical role in inflammation and immunity, and therapeutic inhibition of TNF with antagonist could potentially lead to immune suppression. Data gathered from clinical trials and clinical observation show a minor but significant increased risk of infections in patients suffering from rheumatic diseases treated with monoclonal TNF antibodies and soluble TNF receptors. This increase risk applies to patients but also to the underlying disease. Pathogens causing these infections include intracellular bacteria, and to some extend opportunistic microorganisms as mycobacteria and fungi. Preventive strategies and patient selection have an important impact on the risk of these infections.