Safety of biologic therapies - An update

Tumor necrosis factor (TNF) antagonists have set a new therapeutic standard for rheumatoid arthritis (RA). Agents including infliximab, etanercept, and adalimumab have demonstrated substantial improvement in signs and symptoms, disability, and quality of life, while significantly inhibiting joint damage in early and long-standing RA. Safety issues in concert with efficacy determine risk/benefit ratio and hence a position in the therapeutic algorithm. This brief review focuses on infection, congestive heart, and malignancy.