Risk of Tuberculosis Higher With Certain TNF Blockers

Treatment with TNF blockers has been associated with an increased risk of developing tuberculosis (TB) -- mostly due to reactivation of a latent TB infection. TNF blockers are a treatment option for inflammatory diseases such as rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis.

A French study, published in the July 2009 issue of Arthritis & Rheumatism, looked at possible differences among three TNF blockers (Enbrel, Remicade, and Humira) in terms of TB risk. Researchers set up a national registry in France to find all cases of TB that occurred over a 3-year period among patients given a TNF blocker for any indication. They found 69 cases of TB and assessed their history before and after being given the TNF blocker.

Researchers found that the risk of TB was higher among patients receiving monoclonal TNF blockers (Remicade and Humira) compared to those receiving a soluble TNF blocker (Enbrel). The risk was higher during the first year of treatment also -- suggestive of reactivation of latent TB. Two-thirds of the patients who developed TB had negative skin tests initially. Though the mechanism was not fully understood by researchers, they felt the way specific T helper cells and T regulatory cells (immune cells) are affected by the two types of TNF blockers may explain the difference in risk of TB.

Related Resources:

• TNF-alpha Blockers - What You Need to Know
• What Is a Monoclonal Antibody?
• The Facts of Enbrel
• The Facts of Remicade
• The Facts of Humira

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