|Clinical Tid Bits:
Remicade (infliximab) and Enbrel
(etanercept) could lead to increases in tuberculosis (TB). Both drugs
work by suppressing tumor necrosis factor (TNF) which leads to a reduced
inflamtory response in rheumatoid arthritis. These drugs can also
cause immunosuppression which could worsen a TB infection. Recommendation:
screen for TB before starting these drugs.
Remicade (infliximab) can worsen
moderate to severe congestive heart failure (CHF).
This is a surprise to researchers since it was believed that the TNF blocking
action of infliximab would improve CHF. Recommendation:
Avoid infliximab in patients with heart failure, and monitor for CHF in
patients being treated with this drug.