Safety of Anti-TNFs in Patients with Immune-Mediated Disease

In chronic inflammatory disease, TNF-α is produced in high concentrations, leading to excessive inflammation and eventually organ damage. The advent of anti-TNF therapy in clinical practice 20 years ago represented a significant change in the management of immune-mediated inflammatory diseases (IMID). Common concerns regarding the safety profile of anti-TNFs include increased infection rates, associations with cancer, and safety in pregnancy. Regulatory authority guidelines to reduce risk include vaccination and screening for latent infections prior to treatment initiation. In general, pharmacovigilance and tailored medicine are the best methods for optimising anti-TNF therapy while minimising side effects. This mini review aims to summarise the current understanding of the safety profile of this drug class.