J Korean Rheum Assoc.  2009 Dec;16(4):264-270.

Use of TNF Inhibitor in Particular Clinical Settings

• Lee SH

Abstract

Tumor necrosis factor (TNF) inhibitors have been established as therapeutic agents for treating refractory systemic rheumatic diseases including rheumatoid arthritis and ankylosing spondylitis. While TNF inhibitors can effectively decrease the inflammation, they also decrease resistance to infection and affect immune surveillance mechanisms. Clinicians are sometimes faced with special situations such as chronic hepatitis B infection, pregnancy, complicated medical problems and older populations when prescribing TNF inhibitors. These conditions are affected by TNF inhibitors, which may induce poor clinical outcomes as well as side effects. To date, there are limited clinical data and recommendation guidelines on patients receiving TNF inhibitors in these special situations. We reviewed the effect of TNF inhibitors on each condition with review of the literatures concerning the clinical trials of TNF inhibitors in various rheumatic conditions. TNF inhibitors should be introduced carefully in special situations affecting the outcome of underlying illness, depending on the risk/benefit profiles in each case.

Keyword

TNF inhibitors; HBV; Pregnancy; Chronic renal disease; Congestive heart failure

MeSH Terms

Arthritis, Rheumatoid
Heart Failure
Hepatitis B, Chronic
Humans
Inflammation
Pregnancy
Renal Insufficiency, Chronic
Rheumatic Diseases
Spondylitis, Ankylosing
Tumor Necrosis Factor-alpha
Tumor Necrosis Factor-alpha

Reference

References

1. Choy EH, Panayi GS. Cytokine pathways and joint inflammation in rheumatoid arthritis. N Engl J Med. 2001; 344:907–16.

2. Hyrich KL, Deighton C, Watson KD, Symmons DP, Lunt M. Benefit of anti-TNF therapy in rheumatoid arthritis patients with moderate disease activity. Rheumatology (Oxford). 2009; 48:1323–7.

3. Winthrop KL, Chiller T. Preventing and treating biologic-associated opportunistic infections. Nat Rev Rheumatol. 2009; 5:405–10.

4. Chikura B, Sadananda V, Usman-Saeed M. Comment on: Screening for Mycobacterium tuberculosis prior to anti-TNF therapy–an audit of impact of the British Thoracic Society guidelines on rheumatology practice in an area of low Mycobacterium tuberculosis prevalence. Rheumatology (Oxford). 2009; 48:1331–2.

5. Cush JJ. Unusual toxicities with TNF inhibition: heart failure and drug-induced lupus. Clin Exp Rheumatol. 2004; 22(5 Suppl 35):S141–7.

6. Guidotti LG, Chisari FV. Noncytolytic control of viral infections by the innate and adaptive immune response. Annu Rev Immunol. 2001; 19:65–91.

7. Herbein G, O'Brien WA. Tumor necrosis factor (TNF)-alpha and TNF receptors in viral pathogenesis. Proc Soc Exp Biol Med. 2000; 223:241–57.

8. Kasahara S, Ando K, Saito K, Sekikawa K, Ito H, Ishikawa T, et al. Lack of tumor necrosis factor alpha induces impaired proliferation of hepatitis B virus-specific cytotoxic T lymphocytes. J Virol. 2003; 77:2469–76.

9. Liang R. How I treat and monitor viral hepatitis B infection in patients receiving intensive immunosuppressive therapies or undergoing hematopoietic stem cell transplantation. Blood. 2009; 113:3147–53.

10. Chung SJ, Kim JK, Park MC, Park YB, Lee SK. Reactivation of hepatitis B viral infection in inactive HBsAg carriers following antitumor necrosis factor-alpha therapy. J Rheumatol. 2009; 36:2416–20.

11. Shale MJ. The implications of anti-tumour necrosis factor therapy for viral infection in patients with inflammatory bowel disease. Br Med Bull. 2009; 92:61–77.

12. Roux CH, Brocq O, Breuil V, Albert C, Euller-Ziegler L. Safety of anti-TNF-alpha therapy in rheumatoid arthritis and spondylarthropathies with concurrent B or C chronic hepatitis. Rheumatology (Oxford). 2006; 45:1294–7.

13. Thiele DL. Is anti-TNF therapy safe in patients with rheumatic disease who also have concurrent B or C chronic hepatitis? Nat Clin Pract Rheumatol. 2007; 3:130–1.

14. Lai CL, Dienstag J, Schiff E, Leung NW, Atkins M, Hunt C, et al. Prevalence and clinical correlates of YMDD variants during lamivudine therapy for patients with chronic hepatitis B. Clin Infect Dis. 2003; 36:687–96.

15. Lok AS, McMahon BJ. Chronic hepatitis B. Hepatology. 2007; 45:507–39.

16. Li S, Kaur PP, Chan V, Berney S. Use of tumor necrosis factor-alpha (TNF-alpha) antagonists infliximab, etanercept, and adalimumab in patients with concurrent rheumatoid arthritis and hepatitis B or hepatitis C: a retrospective record review of 11 patients. Clin Rheumatol. 2009; 28:787–91.

17. Nathan DM, Angus PW, Gibson PR. Hepatitis B and C virus infections and antitumor necrosis factor-alpha therapy: guidelines for clinical approach. J Gastroenterol Hepatol. 2006; 21:1366–71.

18. Vauloup C, Krzysiek R, Greangeot-Keros L, Wendling D, Goupille P, Brault R, et al. Effects of tumor necrosis factor antagonist treatment on hepatitis C-related immunological abnormalities. Eur Cytokine Netw. 2006; 17:290–3.

19. Sinha A, Patient C. Rheumatoid arthritis in pregnancy: successful outcome with anti-TNF agent (Etanercept). J Obstet Gynaecol. 2006; 26:689–91.

20. Katz JA, Antoni C, Keenan GF, Smith DE, Jacobs SJ, Lichtenstein GR. Outcome of pregnancy in women receiving infliximab for the treatment of Crohn's disease and rheumatoid arthritis. Am J Gastroenterol. 2004; 99:2385–92.

21. Burt MJ, Frizelle FA, Barbezat GO. Pregnancy and exposure to infliximab (antitumor necrosis factor-alpha monoclonal antibody). J Gastroenterol Hepatol. 2003; 18:465–6.

22. Mishkin DS, Van Deinse W, Becker JM, Farraye FA. Successful use of adalimumab (Humira) for Crohn's disease in pregnancy. Inflamm Bowel Dis. 2006; 12:827–8.

23. Carter JD, Valeriano J, Vasey FB. Tumor necrosis factor-alpha inhibition and VATER association: a causal relationship. J Rheumatol. 2006; 33:1014–7.

24. Carter JD, Ladhani A, Ricca LR, Valeriano J, Vasey FB. A safety assessment of tumor necrosis factor antagonists during pregnancy: a review of the Food and Drug Administration database. J Rheumatol. 2009; 36:635–41.

25. Skomsvoll JF, Wallenius M, Koksvik HS, Rodevand E, Salvesen KA, Spigset O, et al. Drug insight: antitumor necrosis factor therapy for inflammatory arthropathies during reproduction, pregnancy and lactation. Nat Clin Pract Rheumatol. 2007; 3:156–64.

26. Kremer JM, Petrillo GF, Hamilton RA. Pharmacokinetics and renal function in patients with rheumatoid arthritis receiving a standard dose of oral weekly methotrexate: association with significant decreases in creatinine clearance and renal clearance of the drug after 6 months of therapy. J Rheumatol. 1995; 22:38–40.

27. Schiff MH, Whelton A. Renal toxicity associated with disease-modifying antirheumatic drugs used for the treatment of rheumatoid arthritis. Semin Arthritis Rheum. 2000; 30:196–208.

28. Gottenberg JE, Merle-Vincent F, Bentaberry F, Allanore Y, Berenbaum F, Fautrel B, et al. Anti-tumor necrosis factor alpha therapy in fifteen patients with AA amyloidosis secondary to inflammatory arthritides: a followup report of tolerability and efficacy. Arthritis Rheum. 2003; 48:2019–24.

29. Hammoudeh M. Infliximab treatment in a patient with rheumatoid arthritis on haemodialysis. Rheumatology (Oxford). 2006; 45:357–9.

30. Cho SK, Sung YK, Park S, Bae SC. Etanercept treatment in rheumatoid arthritis patients with chronic kidney failure on predialysis. Rheumatol Int 2009. Epub ahead of.

31. Levine B, Kalman J, Mayer L, Fillit HM, Packer M. Elevated circulating levels of tumor necrosis factor in severe chronic heart failure. N Engl J Med. 1990; 323:236–41.

32. Sarzi-Puttini P, Atzeni F, Shoenfeld Y, Ferraccioli G. TNF-alpha, rheumatoid arthritis, and heart failure: a rheumatological dilemma. Autoimmun Rev. 2005; 4:153–61.

33. Mann DL, McMurray JJ, Packer M, Swedberg K, Borer JS, Colucci WS, et al. Targeted anticytokine therapy in patients with chronic heart failure: results of the Randomized Etanercept Worldwide Evaluation (RENEWAL). Circulation. 2004; 109:1594–602.

34. Kwon HJ, Cote TR, Cuffe MS, Kramer JM, Braun MM. Case reports of heart failure after therapy with a tumor necrosis factor antagonist. Ann Intern Med. 2003; 138:807–11.

35. Listing J, Strangfeld A, Kekow J, Schneider M, Kapelle A, Wassenberg S, et al. Does tumor necrosis factor alpha inhibition promote or prevent heart failure in patients with rheumatoid arthritis? Arthritis Rheum. 2008; 58:667–77.

36. Danila MI, Patkar NM, Curtis JR, Saag KG, Teng GG. Biologics and heart failure in rheumatoid arthritis: are we any wiser? Curr Opin Rheumatol. 2008; 20:327–33.

37. Goronzy JJ, Fujii H, Weyand CM. Telomeres, immune aging and autoimmunity. Exp Gerontol. 2006; 41:246–51.

38. Klotz U. Pharmacokinetics and drug metabolism in the elderly. Drug Metab Rev. 2009; 41:67–76.

39. Fleischmann R, Iqbal I. Risk: benefit profile of etanercept in elderly patients with rheumatoid arthritis, ankylosing spondylitis or psoriatic arthritis. Drugs Aging. 2007; 24:239–54.

40. Bongartz T, Sutton AJ, Sweeting MJ, Buchan I, Matteson EL, Montori V. Anti-TNF antibody therapy in rheumatoid arthritis and the risk of serious infections and malignancies: systematic review and metaanalysis of rare harmful effects in randomized controlled trials. Jama. 2006; 295:2275–85.

41. Takeuchi T, Tatsuki Y, Nogami Y, Ishiguro N, Tanaka Y, Yamanaka H, et al. Postmarketing surveillance of the safety profile of infliximab in 5000 Japanese patients with rheumatoid arthritis. Ann Rheum Dis. 2008; 67:189–94.

42. Stone JH, Holbrook JT, Marriott MA, Tibbs AK, Sejismundo LP, Min YI, et al. Solid malignancies among patients in the Wegener's Granulomatosis Etanercept Trial. Arthritis Rheum. 2006; 54:1608–18.

43. Rennard SI, Fogarty C, Kelsen S, Long W, Ramsdell J, Allison J, et al. The safety and efficacy of infliximab in moderate to severe chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2007; 175:926–34.