The Evaluation of Drug Side Effect Profiles in Patients with Inflammatory Rheumatic Disease Using Tumor Necrosis Factor-Alpha Inhibitors

INTRODUCTION: The use of TNF alpha (TNF-α) inhibitors is associated with potential side effects such as infusion reactions, anaphylaxis, development of infection, and cutaneous and paradoxical side effects. We aimed to evaluate the side effects observed with the use of these agents in patients with rheumatic diseases followed by TNF-α inhibitors in our clinic.
METHODS: Patients admitted to our clinic in the last 5 years with a diagnosis of inflammatory rheumatic disease and treated with TNF-α inhibitors were included in the study. Demographic data, diagnoses, treatment, and side effects were recorded. Statistical analysis was performed using SPSS 21.0.
RESULTS: Forty-two patients with rheumatic disease receiving TNF-α inhibitors were analyzed. Infliximab caused cutaneous side effects in 26 patients, including one infusion reaction and two cases of anaphylaxis. These side effects included allergic rash, psoriasis, bullous pemphigoid, dermatitis herpetiformis, erythema ab igne, dermatitis, and small vessel vasculitis. Golimumab caused neutropenia in two patients. Other adverse events were cervical intraepithelial lesions and Kaposi's sarcoma in one patient with psoriatic arthritis. Infections were the most common adverse events and were reported in four patients.
DISCUSSION AND CONCLUSION: TNF-α inhibitors are widely used in inflammatory rheumatic diseases. These agents have side effects and it is important to be aware of and cautious about potential side effects.