Does Anti–Tumor Necrosis Factor α Therapy Increase the Risk for Serious Infection?

Several earlier studies have shown a roughly twofold higher risk for serious infections in anti–tumor necrosis factor α (TNF-α) recipients than in recipients of other drugs. The increased risk was noted mostly in the first months of therapy, but whether declining rates over time reflect self-selection as patients with the highest risks for infection drop out of continuing therapy is unknown.

Authors of this retrospective analysis compared rates of infection-related hospitalizations in the first 12 months after initiation of therapy in a large cohort of patients with autoimmune disease (rheumatoid arthritis, inflammatory bowel disease, or psoriasis and spondyloarthropathies) who received anti–TNF-α agents (primarily etanercept, infliximab, an…