Rheumatoid Arthritis (RA)
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    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.

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Copyright © 2001 Scott Toste, Pharm.D., R.Ph.
Last updated: 12/11/01