Risk of Infections in patients using Anti-TNF Medications: A Literature Review

Abstract

The paradigm for treating chronic Autoimmune Rheumatic Disorders (ARDs) has changed thanks to biologic disease-modifying anti-rheumatic medicines (bDMARDs), however one of its most significant adverse effects is an elevated risk of infections. The current research assessed the incidence, severity, and type of infections in ARD patients on bDMARDs. Disease activity is interwoven with both infectious and chronic inflammatory diseases. Infections are more likely to occur in people with Rheumatoid Arthritis as high disease activity actually reflects persistent inflammation, which may weaken immunity and encourage the spread of various types of infections. Those with RA had an adjusted risk of being hospitalized with an infection that was two times greater when age, sex, concomitant conditions, and prescription medication use were taken into consideration. The risk of mycobacterial infection appears to be lowest with Etanercept (ETN) and highest with Adalimumab (ADA) and Infliximab (INF). Centers of Disease Control and Prevention (CDC) recommends administration of shingles vaccine to all individuals who are on Tumor Necrosis Factor (TNF) inhibitors to prevent Skin and Soft Tissue Infections (SSTI).