Clinical Microbiology and Antimicrobial Chemotherapy. 2006; 8(4):314-324
Tumor necrosis factor (TNF)-blocking agents are one of the new option in the treatment of immune-mediated inflammatory diseases, such as rheumatoid arthritis, Crohn disease, ulcerative colitis. However, anti-TNF therapy is associated with the increased risk for sever infections (pneumonia, sepsis) and probability for the reactivation of latent infections, mainly tuberculosis. This paper reviews the clinical data from clinical and post-marketing studies on assessment of the risk for severe infections, as well as information from the large national registries of patients under anti-TNF therapy. A focus on issues concerning activation of tuberculosis in patients receiving TNF-blocking agents was made. Incidence rates of latent and active tuberculosis during the administration of infliximab and other TNF antagonists were presented. Also, general key points of the recently developed national guidelines for the screening of latent tuberculosis infection in candidates for anti-TNF therapy, diagnosis and treatment of tuberculosis in patients under anti-TNF therapy were presented.