Rheumatology Book


TNF Inhibitor

Aka: TNF Inhibitor, Anti-TNF Agent, Tumor Necrosis Factor Inhibitor, TNF-a blockers, Tumor Necrosis Factor Alpha Inhibitor
  1. See Also
    1. Monoclonal Antibody
    2. Biological Agent Therapy for Malignant Disease
  2. Indications: Autoimmune Conditions
    1. FDA Approved
      1. Rheumatoid Arthriitis
      2. Juvenile polyarticular Rheumatoid Arthritis
      3. Spondyloarthropathy (e.g. Ankylosing Spondylitis)
      4. Inflammatory Bowel Disease (Crohns Disease, Ulcerative Colitis)
      5. Psoriasis
      6. Psoriatic Arthritis
    2. Off-Label
      1. Sarcoidosis
      2. Hidradenitis suppuritiva
      3. Adamantiades-Behcet's Disease
      4. Pyoderma Gangrenosum
      5. Dermatomyositis
      6. Scleroderma
      7. Noninfectious Uveitis
  3. Preparations
    1. Older xTNF agents included Thalidomide
    2. Modern xTNF agents (in 2016) are primarily monoclonal antibodies
      1. Examples include Infliximab (Remicade), Adalimumab (Humira) and Etanercept (Enbrel)
  4. Complications
    1. Nonmelanoma Skin Cancer
    2. Congestive Heart Failure (Infliximab)
      1. Behnam (2005) Skinmed 4(6):363-8 +PMID:16276152 [PubMed]
    3. Multiple Sclerosis
      1. Kemanetzoglou (2017) Curr Neurol Neurosci Rep 17(4): 36 +PMID: 28337644 [PubMed]
    4. Opportunistic Infection or reactivated infections
      1. Tuberculosis
        1. Screen for latent infection prior to initiating TNF agent
      2. Disseminated Histoplasmosis
      3. Coccidioidomycosis
      4. Blastomycosis
      5. Hepatitis B
      6. Cytomegalovirus
      7. Leishmaniasis
    5. References
      1. Toussi (2013) Clin Infect Dis 57:1318–30 +PMID:23899685 [PubMed]
  5. Prevention
    1. Update Vaccinations prior to starting therapy (Live Vaccines may not be used with xTNF agents)
    2. Screen for Tuberculosis and other infections prior to starting xTNF-a agents
    3. Requires regular lab monitoring depending on agent and condition being treated
    4. Skin Cancer Prevention with regular use of Sunscreen and Self Skin Exam
    5. Patients should seek medical evaluation for acute infectious symptoms while on xTNF agents
  6. References
    1. (2018) Presc Lett 25(7): 40

Anti-tumor necrosis factor alpha drug (C1562242)

Concepts Pharmacologic Substance (T121)
SnomedCT 420693002, 416897008
English Anti-tumor necrosis factor alpha agent (substance), Anti-tumor necrosis factor alpha agent, Anti-tumour necrosis factor alpha agent, Anti-TNF drug, Anti-tumor necrosis factor alpha drug (product), Anti-tumor necrosis factor alpha drug, Anti-tumour necrosis factor alpha drug
Spanish agente con anti-factor de necrosis tumoral alfa (sustancia), agente con FNT-alfa, agente con TNF-alfa, agente con anti-factor de necrosis tumoral alfa, factor de necrosis tumoral alfa (producto), factor de necrosis tumoral alfa
Derived from the NIH UMLS (Unified Medical Language System)

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