What is a major adverse effect of TNF inhibitors such as infliximab or adalimumab?

What is a major adverse effect of TNF inhibitors such as infliximab or adalimumab?

• A. Hypertension
• B. Hyperglycemia
• C. Nephrotoxicity
• D. Infection due to immunosuppression

Answer: (D)

TNF inhibitors blunt the immune response by blocking TNF-alpha, a cytokine essential for activating macrophages and coordinating defenses against infections. Because this dampens the body's ability to fight microbes, patients become more susceptible to infections, including serious and opportunistic ones. Infliximab and adalimumab are well-known for this risk, which is why infection stands out as the major adverse effect. Other options aren’t the primary concerns with these agents. Hypertension, hyperglycemia, and nephrotoxicity are not typical major adverse effects of TNF inhibitors, though other drugs or conditions can cause those problems. The key clinical takeaway is to screen for latent TB before starting therapy and monitor for infection during treatment, pausing therapy if a serious infection occurs.

TNF inhibitors blunt the immune response by blocking TNF-alpha, a cytokine essential for activating macrophages and coordinating defenses against infections. Because this dampens the body's ability to fight microbes, patients become more susceptible to infections, including serious and opportunistic ones. Infliximab and adalimumab are well-known for this risk, which is why infection stands out as the major adverse effect.

Other options aren’t the primary concerns with these agents. Hypertension, hyperglycemia, and nephrotoxicity are not typical major adverse effects of TNF inhibitors, though other drugs or conditions can cause those problems. The key clinical takeaway is to screen for latent TB before starting therapy and monitor for infection during treatment, pausing therapy if a serious infection occurs.