Noninfectious and nonmalignant complications of anti-TNF therapy

Abstract

Anti-TNF therapies are commonly used in the treatment of moderate to severe inflammatory bowel disease. The noninfectious and nonmalignant complications of anti-TNF therapy include infusion or injection site reactions, psoriasiform and eczematous eruptions, lupus-like reaction, hepatotoxicity, demyelination, and heart failure. Infusion/injection site and dermatologic reactions often can be managed with supportive care without discontinuation of the anti-TNF. Early recognition and management of these complications is important to initiate supportive care if indicated, to minimize symptoms, and to transition to other therapies if necessary. This chapter focuses on the clinical presentation, pathophysiology, diagnostic evaluation, and management of the noninfectious and nonmalignant complications of anti-TNF therapy.