What are the contraindications to the use of tumor necrosis factor (TNF) inhibitors in the treatment of rheumatoid arthritis (RA)?

Updated: Feb 07, 2020
  • Author: Howard R Smith, MD; Chief Editor: Herbert S Diamond, MD  more...
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Answer

Acute and chronic infections, demyelinating disorders, class III or IV heart failure, and recent malignancies are contraindications to the use of TNF inhibitors. Thoroughly searching for latent tuberculosis using purified protein derivative (PPD) testing or an interferon (IFN) gamma release assay (IGRA), with or without chest radiography, is recommended before these agents are started.


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