Risks for Infection with Tumor Necrosis Factor Antagonists

Tumor necrosis factor (TNF) antagonists are valuable medications for treating psoriasis and psoriatic arthritis. This class of agents includes anti-TNF antibodies, such as infliximab and adalimumab, and soluble TNF receptors that bind TNF and lymphotoxin, such as etanercept. The authors of this review compare the risk for infections with the two types of TNF antagonists.

The granulomatous infections tuberculosis, histoplasmosis, and coccidioidomycosis were 2 to 7 times more likely to occur during infliximab than during etanercept therapy. Other studies have demonstrated that tuberculosis is 2 to 15 times more common with adalimumab or infliximab than with etanercept. Most tuberculosis infections occur shortly after therapy is begun, suggesti…