Infection complications associated with the use of biologic agents

The advent of biologic agents that target proinflammatory cytokines such as interleukin-1 (IL-1) or tumor necrosis factor alpha (TNFalpha) has revolutionized the understanding of the pathophysiology of inflammatory diseases and has given new hope to patients suffering from these disorders. Both IL-1 and TNFalpha play pivotal roles in inflammation and enhance the pathologic events in rheumatoid arthritis (RA) and other inflammatory arthropathies. Several clinical trials have evaluated a variety of therapeutic interventions that specifically block the effects of these biologic agents. Interleukin-1 receptor antagonist (IL-1Ra) has clinical, radiologic, and histologic benefits in patients with RA. Anti-TNFalpha agents such as infliximab, etanercept, and adalimumab are also efficacious in the management of inflammatory arthropathies.