Correspondence
Invasive Pulmonary Aspergillosis Associated with Infliximab Therapy
N Engl J Med 2001; 344:1099-1100April 5, 2001
- Article
To the Editor:
A 25-year-old man with fistulizing Crohn's disease began to have high fever, dyspnea, and a productive cough five days after he received a single intravenous dose of 5 mg of a monoclonal antibody against tumor necrosis factor α (anti–TNF-α antibody; infliximab, Centocor, Malvern, Pa.) per kilogram of body weight. His current medications did not include corticosteroids or other immunosuppressive drugs. His chest roentgenogram showed massive, bilateral infiltrates, and laboratory examination revealed an elevated C-reactive protein value and leukocytosis. He received treatment with intravenous broad-spectrum antibiotics. Within 24 hours after admission, respiratory insufficiency developed. Ventilatory support and extracorporeal membrane oxygenation were needed to achieve adequate oxygenation. On day 7, Aspergillus fumigatus was grown from a culture of tracheal secretions but was considered clinically nonsignificant. Treatment with high-dose corticosteroids was started because of adult respiratory distress syndrome. On day 13, cultures of tracheal secretions and bronchoalveolar-lavage fluid repeatedly yielded A. fumigatus, and treatment with liposomal amphotericin B (3 mg per kilogram per day) was started. The results of bacteriologic and virologic examinations remained negative. The results of analyses for TNF-α and aspergillus antigen on serial plasma samples were negative. A hemothorax developed. Samples obtained during a thoracotomy on day 22 showed growth of A. fumigatus, and results of antigen testing were positive. Despite the intensive treatment, the patient died from multiorgan failure and septic shock on day 24. Postmortem examination of lung tissue showed invasive growth of septated hyphae, and cultures revealed A. fumigatus.
Systemic use of anti–TNF-α antibodies is not a known risk factor for invasive aspergillosis. As far as we know, this is the first reported case of invasive aspergillosis associated with this treatment. The patient had had no known risk factors associated with invasive aspergillosis. He had not had neutropenia; he had not taken corticosteroids or other immunosuppressive drugs during the three months before he received anti–TNF-α treatment; and he had not had a prior influenza infection or any known exposures to aspergillus. In addition, he had been a nonsmoker and had not used marijuana.
TNF-α is thought to have a central role in the immunopathology of inflammatory bowel disease, and several trials have shown a clinical benefit of infliximab.1-3 Infliximab reduces intestinal inflammation by binding to and neutralizing TNF-α on the cell membrane and by destroying TNF-α–producing cells in the blood. However, TNF-α also has a central role in the recruitment of neutrophils into the lungs in response to pathogens such as A. fumigatus. 4,5 In both normal and neutropenic mice, antibody-mediated neutralization of TNF-α resulted in an increase in mortality after intratracheal challenge with A. fumigatus. 5
Serious infectious complications with the use of infliximab have been reported rarely, although the incidence of upper respiratory tract infections with infliximab is higher than that with placebo.1
The systemic use of monoclonal antibodies against TNF-α in patients with inflammatory bowel disease increases the risk of serious opportunistic infections by inhibiting an adequate TNF-α response. Practitioners should be aware of this risk when treating patients with anti–TNF-α antibodies.
5 ReferencesAdilia Warris, M.D.
University Medical Center St. Radboud, 6500 HB Nijmegen, the NetherlandsArvid Bjørneklett, M.D., Ph.D.
Peter Gaustad, M.D., Ph.D.
National Hospital of the University of Oslo, 0027 Oslo, Norway1
van Deventer SJH . Anti-TNF antibody treatment of Crohn's disease. Ann Rheum Dis 1999;58:Suppl I:I-114
CrossRef2
D'haens G ,van Deventer S ,van Hogezand R , et al. Endoscopic and histological healing with infliximab anti-tumor necrosis factor antibodies in Crohn's disease: a European multicenter trial. Gastroenterology 1999;116:1029-1034
CrossRef | Web of Science | Medline3
Targan SR ,Hanauer SB ,van Deventer SJH , et al. A short-term study of chimeric monoclonal antibody cA2 to tumor necrosis factor α for Crohn's disease. N Engl J Med 1997;337:1029-1035
Full Text | Web of Science | Medline4
Schelenz S ,Smith DA ,Bancroft GJ . Cytokine and chemokine responses following pulmonary challenge with Aspergillus fumigatus: obligatory role of TNF-alpha and GM-CSF in neutrophil recruitment. Med Mycol 1999;37:183-194
CrossRef | Web of Science | Medline5
Mehrad B ,Strieter RM ,Standiford TJ . Role of TNF-α in pulmonary host defense in murine invasive aspergillosis. J Immunol 1999;162:1633-1640
Web of Science | Medline
Author/Editor Response
The above letter was referred to Centocor, the manufacturer of infliximab, which offers the following reply:
To the Editor: Fungal infections in patients treated with infliximab are rare. As of January 31, 2001, more than 2000 patients have received infliximab in clinical trials. Fungal infections have occurred in only two of these patients (<0.1 percent). One patient, described in a previous report,1 had disseminated coccidioidomycosis while receiving concurrent corticosteroids and methotrexate with infliximab, and another patient, in a controlled trial that is currently blinded, had cryptococcal pneumonia; it is not known whether this patient received infliximab or placebo.
Since the approval of infliximab by the Food and Drug Administration for Crohn's disease in 1998 and for rheumatoid arthritis in 1999, nearly 115,000 patients have received infliximab. Post-marketing reports of documented systemic fungal infections through January 31, 2001, reveal the following: six cases of aspergillosis, including the case described by Warris et al. (three of which involved treatment with profound immunosuppression for graft-versus-host disease before treatment with infliximab for that disease), five cases of Pneumocystis carinii pneumonia, three cases of histoplasmosis (one primary and two disseminated), one case of a coccidioidomycosis septic joint, three cases of systemic candida infections, and five cases of systemic unspecified fungal infections (several of the patients with candida or unspecified fungal infections had central venous catheters, with or without total parenteral nutrition). In almost all of these cases, there was concurrent immunosuppression including therapy with corticosteroids, azathioprine, methotrexate, or mercaptopurine.
The benefit of infliximab in Crohn's disease and rheumatoid arthritis is well established. Infliximab alters the course of these illnesses by producing clinical remission and healing of fistulas in Crohn's disease2,3 and by reducing signs and symptoms and preventing joint damage in rheumatoid arthritis.1 In addition, reports from several tertiary care centers have shown that infliximab has a corticosteroid-sparing benefit in Crohn's disease,4 which may lessen the need for therapeutic immunosuppression with corticosteroids.
Increased risks of infection associated with immunosuppressive agents such as corticosteroids, azathioprine, methotrexate, and mercaptopurine are recognized. Whether blockade of TNF-α significantly increases the risk of opportunistic fungal infections remains to be established. Finally, invasive pulmonary aspergillosis has been described even in the absence of an immunocompromised state.5 Practitioners need to consider the benefits and risks of all the therapeutic options when developing a treatment plan for patients with Crohn's disease or rheumatoid arthritis.
5 ReferencesGregory F. Keenan, M.D.
Thomas F. Schaible, Ph.D.
Jerome A. Boscia, M.D.
Centocor, Malvern, PA 193551
Lipsky PE ,van der Heijde DMFM ,St Clair EW , et al. Infliximab and methotrexate in the treatment of rheumatoid arthritis. N Engl J Med 2000;343:1594-1602
Full Text | Web of Science | Medline2
Targan SR ,Hanauer SB ,van Deventer SJH , et al. A short-term study of chimeric monoclonal antibody cA2 to tumor necrosis factor α for Crohn's disease. N Engl J Med 1997;337:1029-1035
Full Text | Web of Science | Medline3
Present DH ,Rutgeerts P ,Targan S , et al. Infliximab for the treatment of fistulas in patients with Crohn's disease. N Engl J Med 1999;340:1398-1405
Full Text | Web of Science | Medline4
Cohen RD ,Tsang JF ,Hanauer SB . Infliximab in Crohn's disease: first anniversary clinical experience. Am J Gastroenterol 2000;95:3469-3477
CrossRef | Web of Science | Medline5
Karam GH ,Griffin FM . Invasive pulmonary aspergillosis in nonimmunocompromised, nonneutropenic hosts. Rev Infect Dis 1986;8:357-363
CrossRef | Medline
- Citing Articles (126)
Citing Articles
1
Kelly M. Smith, W.S. Wilkie, Philip Schwieterman. (2012) Strategies for the Management of Rheumatoid Arthritis. Orthopedics 35:2, 125-130
CrossRef2
Mary L. Stevenson, Mark Lebwohl. (2011) Iatrogenic effects of biologics for psoriasis. Clinics in Dermatology 29:6, 614-621
CrossRef3
Gert Van Assche, James D Lewis, Gary R Lichtenstein, Edward V Loftus, Qin Ouyang, Julian Panes, Corey A Siegel, William J Sandborn, Simon P L Travis, Jean-Frederic Colombel. (2011) The London Position Statement of the World Congress of Gastroenterology on Biological Therapy for IBD With the European Crohn's and Colitis Organisation: Safety. The American Journal of Gastroenterology 106:9, 1594-1602
CrossRef4
Sarah OʼDonnell, Stephen Murphy, Malik M. Anwar, Maria OʼSullivan, Niall Breslin, Humphrey J. OʼConnor, Barbara M. Ryan, Colm A. OʼMorain. (2011) Safety of infliximab in 10 years of clinical practice. European Journal of Gastroenterology & Hepatology 23:7, 603-606
CrossRef5
Jae Hee Kim, Joong Ki Bae, Jae Wan Jun, Hyun Sung Lee, Hyung Wook Ju, Ji Seon Oh, Seung Won Choi. (2011) A Case of Invasive Pulmonary Aspergillosis in a Patient with Rheumatoid Arthritis Treated with Adalimumab. Journal of Rheumatic Diseases 18:3, 212
CrossRef6
Natalia Pedersen, Dana Duricova, Martin Lenicek, Margarita Elkjaer, Martin Bortlik, Paal Skytt Andersen, Libor Vitek, Bogi Davidsen, Vibeke Wewer, Milan Lukas, Pia Munkholm. (2010) Infliximab dependency is related to decreased surgical rates in adult Crohnʼs disease patients. European Journal of Gastroenterology & Hepatology 22:10, 1196-1203
CrossRef7
Brian G Feagan, John WD McDonald. 2010. Crohn's Disease. , 211-231.
CrossRef8
W. Miehsler, G. Novacek, H. Wenzl, H. Vogelsang, P. Knoflach, A. Kaser, C. Dejaco, W. Petritsch, M. Kapitan, H. Maier, W. Graninger, H. Tilg, W. Reinisch. (2010) A decade of infliximab: The Austrian evidence based consensus on the safe use of infliximab in inflammatory bowel disease. Journal of Crohn's and Colitis 4:3, 221-256
CrossRef9
Gustav F. Strandvik, Sara Polhill. (2010) Tumour necrosis factor inhibitors in critical care: Case report with review of the literature. Current Anaesthesia & Critical Care 21:2, 97-100
CrossRef10
Jeannina A. Smith. (2010) Tumor Necrosis Factor Inhibitors and Fungal Infections. Current Fungal Infection Reports 4:1, 38-45
CrossRef11
Shawn Vasoo, Preeti Gurnani, Terence Agustin, Jeehyun Lee, Kamaljit Singh. (2009) Chest Pain as Presenting Symptom of Staphyloccocus aureus Epidural Abscess Associated With Anti-Tumor Necrosis Factor and Methotrexate Therapy. JCR: Journal of Clinical Rheumatology 15:8, 396-398
CrossRef12
Siba P. Raychaudhuri, Caroline T. Nguyen, Smriti K. Raychaudhuri, M. Eric Gershwin. (2009) Incidence and nature of infectious disease in patients treated with anti-TNF agents. Autoimmunity Reviews 9:2, 67-81
CrossRef13
Tamra M. Arnold, Catherine R. Sears, Chadi A. Hage. (2009) Invasive Fungal Infections in the Era of Biologics. Clinics in Chest Medicine 30:2, 279-286
CrossRef14
Tien-Yu Huang, Heng-Cheng Chu, Yi-Ling Lin, Chih-Kung Lin, Tsai-Yuan Hsieh, Wei-Kuo Chang, You-Chen Chao, Ching-Len Liao. (2009) Minocycline attenuates experimental colitis in mice by blocking expression of inducible nitric oxide synthase and matrix metalloproteinases. Toxicology and Applied Pharmacology 237:1, 69-82
CrossRef15
Elizabeth Cerceo, Robert M. Kotloff, Denis Hadjiliadis, Vivek N. Ahya, Alberto Pochettino, Colin Gillespie, Jason D. Christie. (2009) Central Airways Obstruction Due to Aspergillus fumigatus After Lung Transplantation. The Journal of Heart and Lung Transplantation 28:5, 515-519
CrossRef16
Cabot, Richard C.Harris, Nancy Lee, Shepard, Jo-Anne O., Rosenberg, Eric S., Cort, Alice M., Ebeling, Sally H.Peters, Christine C., Weinblatt, Michael E., Abbott, Gerald F., Koreishi, Aashiyana F., . (2009) Case 13-2009. New England Journal of Medicine 360:17, 1770-1779
Full Text17
D. DURICOVA, N. PEDERSEN, M. LENICEK, O. HRADSKY, J. BRONSKY, M. ADAMCOVA, M. ELKJAER, P. S. ANDERSEN, L. VITEK, K. LARSEN, M. LUKAS, J. NEVORAL, V. WEWER, P. MUNKHOLM. (2009) Infliximab dependency in children with Crohn’s disease. Alimentary Pharmacology & Therapeutics 29:7, 792-799
CrossRef18
C. W. LEES, A. I. ALI, A. I. THOMPSON, G.-T. HO, R. O. FORSYTHE, L. MARQUEZ, C. J. COCHRANE, S. AITKEN, J. FENNELL, P. ROGERS, A. G. SHAND, I. D. PENMAN, K. R. PALMER, D. C. WILSON, I. D. R. ARNOTT, J. SATSANGI. (2009) The safety profile of anti-tumour necrosis factor therapy in inflammatory bowel disease in clinical practice: analysis of 620 patient-years follow-up. Alimentary Pharmacology & Therapeutics 29:3, 286-297
CrossRef19
James Harris, Jayne. C. Hope, Joseph Keane. (2008) Tumor Necrosis Factor Blockers Influence Macrophage Responses to Mycobacterium tuberculosis. The Journal of Infectious Diseases 198:12, 1842-1850
CrossRef20
Ömer Nuri Pamuk, Yusuf Yesil, Salim Donmez, Ercüment Ünlü, İbrahim Hakkı Köker, Necati Cakir. (2008) The results of purified protein derivative test in ankylosing spondylitis patients: clinical features, HRCT results and relationship with TNF-blocker usage. Rheumatology International 29:2, 179-183
CrossRef21
Sarah Caspersen, Margarita Elkjaer, Lene Riis, Natalia Pedersen, Christian Mortensen, Tine Jess, Pernille Sarto, Tanja S. Hansen, Vibeke Wewer, Flemming Bendtsen, Flemming Moesgaard, Pia Munkholm. (2008) Infliximab for Inflammatory Bowel Disease in Denmark 1999–2005: Clinical Outcome and Follow-Up Evaluation of Malignancy and Mortality. Clinical Gastroenterology and Hepatology 6:11, 1212-1217
CrossRef22
T. M. Hohl, M. Feldmesser, D. S. Perlin, E. G. Pamer. (2008) Caspofungin Modulates Inflammatory Responses to Aspergillus fumigatus through Stage‐Specific Effects on Fungal β‐Glucan Exposure. The Journal of Infectious Diseases 198:2, 176-85
CrossRef23
Adolfo C Fernandez-Obregon, Dhrumil Shah, Amanda I Howell, Imane Tiyal Bentahar, Lester Carrodeguas, Arifa Siddiqui, Julia A Ejiogu. (2008) Challenges in anti-infective therapy for skin conditions: part 2. Expert Review of Dermatology 3:3, 395-411
CrossRef24
Elizabeth C. A. Smith, Christy Riddle, M. Alan Menter, Mark Lebwohl. (2008) Combining systemic retinoids with biologic agents for moderate to severe psoriasis. International Journal of Dermatology 47:5, 514-518
CrossRef25
Y Shirota, GG Illei, NP Nikolov. (2008) Biologic treatments for systemic rheumatic diseases. Oral Diseases 14:3, 206-216
CrossRef26
Mickael Aoun, Jean Klastersky, Kristel Buvé, Johan Maertens. 2008. Management of Fungal Infections in Cancer Patients. , 1-41.
CrossRef27
Tomoyuki Matsumoto, Andres J Quintero, Freddie H Fu, Johnny Huard. (2008) Regenerating musculoskeletal tissues: possibilities for rheumatoid diseases. Future Rheumatology 3:2, 183-197
CrossRef28
J.-P. Gangneux, C. Camus, B. Philippe. (2008) Épidémiologie et facteurs de risque de l’aspergillose invasive du sujet non neutropénique. Revue des Maladies Respiratoires 25:2, 139-153
CrossRef29
Thomas J. Walsh, Elias J. Anaissie, David W. Denning, Raoul Herbrecht, Dimitrios P. Kontoyiannis, Kieren A. Marr, Vicki A. Morrison, Brahm H Segal, William J. Steinbach, David A. Stevens, Jo‐Anne van Burik, John R. Wingard, Thomas F. Patterson. (2008) Treatment of Aspergillosis: Clinical Practice Guidelines of the Infectious Diseases Society of America. Clinical Infectious Diseases 46:3, 327-360
CrossRef30
Emiko Mizoguchi, Yuriko Hachiya, Mayumi Kawada, Katsuya Nagatani, Atsuhiro Ogawa, Ken Sugimoto, Atsushi Mizoguchi, Daniel K. Podolsky. (2008) TNF Receptor Type I-Dependent Activation of Innate Responses to Reduce Intestinal Damage-Associated Mortality. Gastroenterology 134:2, 470-480
CrossRef31
Thomas J. Walsh, Elias J. Anaissie, David W. Denning, Raoul Herbrecht, Dimitrios P. Kontoyiannis, Kieren A. Marr, Vicki A. Morrison, Brahm H Segal, William J. Steinbach, David A. Stevens, Jo‐Anne van Burik, John R. Wingard, y Thomas F. Patterson. (2008) Tratamiento de la Aspergilosis: Guías para la práctica clínica de la Sociedad de Enfermedades Infecciosas de los Estados Unidos de América (IDSA). Clinical Infectious Diseases 46:3, T1-T36
CrossRef32
Sotirios Tsiodras, George Samonis, Dimitrios T. Boumpas, Dimitrios P. Kontoyiannis. (2008) Fungal Infections Complicating Tumor Necrosis Factor α Blockade Therapy. Mayo Clinic Proceedings 83:2, 181-194
CrossRef33
S. Tsiodras, G. Samonis, D. T. Boumpas, D. P. Kontoyiannis. (2008) Fungal Infections Complicating Tumor Necrosis Factor Blockade Therapy. Mayo Clinic Proceedings 83:2, 181-194
CrossRef34
Robert Orenstein, Eric L Matteson. (2007) Opportunistic infections associated with TNF-α treatment. Future Rheumatology 2:6, 567-576
CrossRef35
Tina Ding, Chris Deighton. (2007) Complications of anti-TNF therapies. Future Rheumatology 2:6, 587-597
CrossRef36
Dietlind Schleiermacher, Jörg C. Hoffmann. (2007) Pulmonary abnormalities in inflammatory bowel disease. Journal of Crohn's and Colitis 1:2, 61-69
CrossRef37
Kevin J. Scholten, Vivek Kulkarni, Jay B. Brodsky. (2007) Isolation of the Right Upper-Lobe with a Left-Sided Double-Lumen Tube After Left-Pneumonectomy. Anesthesia & Analgesia 105:2, 330-331
CrossRef38
Brent W. Kinder, Michelle M. Freemer, Talmadge E. King, Raymond F. Lum, Joanne Nititham, Kim Taylor, Jeffrey C. Edberg, S. Louis Bridges, Lindsey A. Criswell. (2007) Clinical and genetic risk factors for pneumonia in systemic lupus erythematosus. Arthritis & Rheumatism 56:8, 2679-2686
CrossRef39
W. Meersseman, K. Lagrou, J. Maertens, E. V. Wijngaerden. (2007) Invasive Aspergillosis in the Intensive Care Unit. Clinical Infectious Diseases 45:2, 205-216
CrossRef40
Mark T. Osterman, Gary R. Lichtenstein. (2007) Current and future anti-TNF therapy for inflammatory bowel disease. Current Treatment Options in Gastroenterology 10:3, 195-207
CrossRef41
Nirmal Kaur, Thomas C. Mahl. (2007) Pneumocystis jiroveci (carinii) Pneumonia After Infliximab Therapy: A Review of 84 Cases. Digestive Diseases and Sciences 52:6, 1481-1484
CrossRef42
Robert S Wallis. (2007) Reactivation of Latent Tuberculosis by TNF Blockade: The Role of Interferon γ. Journal of Investigative Dermatology Symposium Proceedings 12:1, 16-21
CrossRef43
Patricia Muñoz, Maddalena Giannella, Maricela Valerio, Teresa Soria, Fernando Díaz, Javier Lopez Longo, Emilio Bouza. (2007) Cryptococcal meningitis in a patient treated with infliximab. Diagnostic Microbiology and Infectious Disease 57:4, 443-446
CrossRef44
Gilberto Poggioli, Silvio Laureti, Massimo Campieri, Filippo Pierangeli, Paolo Gionchetti, Federica Ugolini, Lorenzo Gentilini, Piero Bazzi, Fernando Rizzello, Maurizio Coscia. (2007) Infliximab in the treatment of Crohn's disease. Therapeutics and Clinical Risk Management 3:2, 301-308
CrossRef45
Johan Maertens. (2007) Evaluating prophylaxis of invasive fungal infections in patients with haematologic malignancies. European Journal of Haematology 78:4, 275-282
CrossRef46
James B. Bussel, Lisa Giulino, Susan Lee, Vivek L. Patel, Christy Sandborg, E. Richard Stiehm. (2007) Update on Therapeutic Monoclonal Antibodies. Current Problems in Pediatric and Adolescent Health Care 37:4, 118-135
CrossRef47
Ziad Reguia??, Florent Grange. (2007) The Role of Anti-Tumor Necrosis Factor-?? Therapy in Pyoderma Gangrenosum Associated with Inflammatory Bowel Disease. American Journal of Clinical Dermatology 8:2, 67-77
CrossRef48
Seung Min Yi, Mie Jin Lim, Seong Ryul Kwon, Jae Cheon Jeong, Jin Soo Lee, Su Hyun Kwon, Lucia Kim, Won Park. (2007) A Case of Cryptococcal Pneumonia in a Rheumatoid Arthritis Patient after Tumor Necrosis Factor-alpha Antagonist Therapy. The Journal of the Korean Rheumatism Association 14:4, 412
CrossRef49
SUSAN J. LEE, ARTHUR KAVANAUGH. (2006) Biologic Agents in Rheumatology: Safety Considerations. Rheumatic Disease Clinics of North America 32, 3-10
CrossRef50
Mark T. Osterman, Gary R. Lichtenstein. (2006) Infliximab in Fistulizing Crohn's Disease. Gastroenterology Clinics of North America 35:4, 795-820
CrossRef51
Jagadeshwar G. Reddy, Edward V. Loftus. (2006) Safety of Infliximab and Other Biologic Agents in the Inflammatory Bowel Diseases. Gastroenterology Clinics of North America 35:4, 837-855
CrossRef52
Lesley Ann Saketkoo, Luis R. Espinoza. (2006) Impact of Biologic Agents on Infectious Diseases. Infectious Disease Clinics of North America 20:4, 931-961
CrossRef53
Daniel E. Furst, Robert Wallis, Michael Broder, David O. Beenhouwer. (2006) Tumor Necrosis Factor Antagonists: Different Kinetics and/or Mechanisms of Action May Explain Differences in the Risk for Developing Granulomatous Infection. Seminars in Arthritis and Rheumatism 36:3, 159-167
CrossRef54
Linda Leff. (2006) Emerging New Therapies in Rheumatoid Arthritis. Journal of Infusion Nursing 29:6, 326-337
CrossRef55
Robert Orenstein. (2006) Infections related to TNF-α inhibitors. Expert Review of Dermatology 1:5, 737-749
CrossRef56
Bart JF van den Bemt, Frank HJ van den Hoogen, Ferdinand C Breedveld,, Hille van der Tempel, Rob Janknegt. (2006) InforMatrix ® : treatment of rheumatoid arthritis using biologicals. Expert Opinion on Pharmacotherapy 7:13, 1769-1789
CrossRef57
Sheetal B. Desai, Daniel E. Furst. (2006) Problems encountered during anti-tumour necrosis factor therapy. Best Practice & Research Clinical Rheumatology 20:4, 757-790
CrossRef58
Kyung-Su PARK, Sung-Hwan PARK. (2006) Adverse effects of tumour necrosis factor-α blocking agents. APLAR Journal of Rheumatology 9:2, 165-169
CrossRef59
John T Chang, Gary R Lichtenstein. (2006) Drug Insight: antagonists of tumor-necrosis factor-α in the treatment of inflammatory bowel disease. Nature Clinical Practice Gastroenterology & Hepatology 3:4, 220-228
CrossRef60
Laurent Beaugerie, Philippe Seksik, Isabelle Nion–Larmurier, Jean–Pierre Gendre, Jacques Cosnes. (2006) Predictors of Crohn’s Disease. Gastroenterology 130:3, 650-656
CrossRef61
A Zwiers, G Bouma. (2006) Recent advances in the etiology and treatment of inflammatory bowel disease. Expert Review of Clinical Immunology 2:2, 245-256
CrossRef62
Tuhina Raman, Paul E Marik. (2006) Fungal infections in bone marrow transplant recipients. Expert Opinion on Pharmacotherapy 7:3, 307-315
CrossRef63
Shunsuke Mori, Fumiya Imamura, Chikage Kiyofuji, Kanako Ito, Yukinori Koga, Izumi Honda, Mineharu Sugimoto. (2006) Pneumocystis jiroveci pneumonia in a patient with rheumatoid arthritis as a complication of treatment with infliximab, anti-tumor necrosis factor α neutralizing antibody. Modern Rheumatology 16:1, 58-62
CrossRef64
2006. Infliximab. , 1747-1753.
CrossRef65
Jason M Bratcher, Burton I Korelitz. (2006) Toxicity of infliximab in the course of treatment of Crohn’s disease. Expert Opinion on Drug Safety 5:1, 9-16
CrossRef66
Nancy F. Crum, Edith R. Lederman, Mark R. Wallace. (2005) Infections Associated With Tumor Necrosis Factor-?? Antagonists. Medicine 84:5, 291-302
CrossRef67
Thomas F Patterson. (2005) Advances and challenges in management of invasive mycoses. The Lancet 366:9490, 1013-1025
CrossRef68
J GARCIALECHUZMOYA. (2005) Complicaciones infecciosas asociadas al uso de fármacos antagonistas del factor de necrosis tumoral. Revisión de conjunto. Enfermedades Infecciosas y Microbiología Clínica 23:9, 551-559
CrossRef69
S PAVY, Y ALLANORE, A KAHAN. (2005) Spondylarthropathies et médicaments anti-TNFα. La Revue de Médecine Interne 26:9, 717-724
CrossRef70
David J. Rychly, Joseph T. DiPiro. (2005) Infections Associated with Tumor Necrosis Factor-α Antagonists. Pharmacotherapy 25:9, 1181-1192
CrossRef71
Mohanad Bakleh, Imad Tleyjeh, Eric L. Matteson, Douglas R. Osmon, Elie F. Berbari. (2005) Infectious complications of tumor necrosis factor-α antagonists. International Journal of Dermatology 44:6, 443-448
CrossRef72
Mimouna Seddik, Hugues Melliez, David Seguy, Nathalie Viget, Antoine Cortot, Jean Frederic Colombel. (2005) Pneumocystis jiroveci (carinii) pneumonia after initiation of infliximab and azathioprine therapy in a patient with Crohn's disease. Inflammatory Bowel Diseases 11:6, 618-620
CrossRef73
Shmuel Shoham, Stuart M. Levitz. (2005) The immune response to fungal infections. British Journal of Haematology 129:5, 569-582
CrossRef74
F. Goldblatt, D. A. Isenberg. (2005) New therapies for rheumatoid arthritis. Clinical and Experimental Immunology 140:2, 195-204
CrossRef75
Calin Popa, Mihai G. Netea, Pilar Barrera, Timothy R.D.S. Radstake, Piet L. van Riel, Bart-Jan Kullberg, Jos W.M. Van der Meer. (2005) Cytokine production of stimulated whole blood cultures in rheumatoid arthritis patients receiving short-term infliximab therapy. Cytokine 30:2, 72-77
CrossRef76
K. Eisendle, P. Fritsch. (2005) Fatal fulminant legionnaires' disease in a patient with severe erythodermic psoriasis treated with infliximab after long-term steroid therapy. British Journal of Dermatology 152:3, 585-586
CrossRef77
E. Domènech, M. Esteve, F. Gomollón, J. Hinojosa, J. Panés, A. Obrador, M.A. Gassull. (2005) Recomendaciones GETECCU-2005 para el uso de infliximab (Remicade®) en la enfermedad inflamatoria intestinal. Gastroenterología y Hepatología 28:3, 126-134
CrossRef78
Thomas Witth
ft, Diether Ludwig. (2005) Effectiveness and tolerability of repeated treatment with infliximab in patients with Crohn?s disease: a retrospective data analysis in Germany. International Journal of Colorectal Disease 20:1, 18-23
CrossRef79
Anne-Marie Tobin, Brian Kirby. (2005) TNF?? Inhibitors in the Treatment of Psoriasis and Psoriatic Arthritis. BioDrugs 19:1, 47-57
CrossRef80
Andreas Pascher, Jochen Klupp. (2005) Biologics in the Treatment of Transplant Rejection and Ischemia/Reperfusion Injury. BioDrugs 19:4, 211-231
CrossRef81
Adilia Warris, Mihai G. Netea, Paul E. Verweij, Peter Gaustad, Bart-Jan Kullberg, Corry M. R. Weemaes, Tore G. Abrahamsen. (2005) Cytokine responses and regulation of interferon-gamma release by human mononuclear cells to Aspergillus fumigatus and other filamentous fungi. Medical Mycology 43:7, 613-621
CrossRef82
Arthur Kavanaugh, Susan J Lee. (2005) Adalimumab for the treatment of rheumatoid arthritis. Therapy 2:1, 13-21
CrossRef83
A. P. Phadke, B. Mehrad. (2005) Cytokines in host defense against Aspergillus : recent advances. Medical Mycology 43:s1, 173-176
CrossRef84
Susan J Lee, Arthur Kavanaugh. (2005) Adalimumab for the treatment of rheumatoid arthritis. Therapy 2:1, 13-21
CrossRef85
Chinyu Su, Gary R. Lichtenstein. (2005) Are there predictors of Remicade treatment success or failure?. Advanced Drug Delivery Reviews 57:2, 237-245
CrossRef86
L. Roberts, G. J. McColl. (2004) Tumour necrosis factor inhibitors: risks and benefits in patients with rheumatoid arthritis. Internal Medicine Journal 34:12, 687-693
CrossRef87
William G. Stebbins, Mark G. Lebwohl. (2004) Biologics in combination with nonbiologics: efficacy and safety. Dermatologic Therapy 17:5, 432-440
CrossRef88
Klaus R. Herrlinger, Annette Borutta, Gabriel Meinhardt, Eduard F. Stange, Klaus Fellermann. (2004) Fatal staphylococcal sepsis in Crohn's disease after infliximab. Inflammatory Bowel Diseases 10:5, 655-656
CrossRef89
Thomas A Judge, Gary R Lichtenstein. (2004) Treatment of fistulizing Crohn's disease. Gastroenterology Clinics of North America 33:2, 421-454
CrossRef90
Georgios I Papachristou, Scott Plevy. (2004) Novel biologics in inflammatory bowel disease. Gastroenterology Clinics of North America 33:2, 251-269
CrossRef91
Wood, Alastair J.J., , Olsen, Nancy J., Stein, C. Michael, . (2004) New Drugs for Rheumatoid Arthritis. New England Journal of Medicine 350:21, 2167-2179
Full Text92
R. S. Wallis, M. S. Broder, J. Y. Wong, M. E. Hanson, D. O. Beenhouwer. (2004) Granulomatous Infectious Diseases Associated with Tumor Necrosis Factor Antagonists. Clinical Infectious Diseases 38:9, 1261-1265
CrossRef93
Donald C. Sheppard, John E. Edwards, Jr.. (2004) Editorial Commentary: Development of a Vaccine for Invasive Aspergillosis. Clinical Infectious Diseases 38:8, 1137-1138
CrossRef94
William S. Mow, Maria T. Abreu-martin, Konstantinos A. Papadakis, Howard E. Pitchon, Stephan R. Targan, Eric A. Vasiliauskas. (2004) High incidence of anergy in inflammatory bowel disease patients limits the usefulness of PPD screening before infliximab therapy. Clinical Gastroenterology and Hepatology 2:4, 309-313
CrossRef95
Mihai G Netea, Bart-Jan Kullberg, Jos W M Van der Meer. (2004) Proinflammatory Cytokines in the Treatment of Bacterial and Fungal Infections. BioDrugs 18:1, 9-22
CrossRef96
Xenofon Baraliakos, Juergen Braun. (2004) Current Concepts in the Therapy of the Spondyloarthritides. BioDrugs 18:5, 307-314
CrossRef97
Jean-Frederic Colombel, Edward V. Loftus, William J. Tremaine, Laurence J. Egan, W.Scott Harmsen, Cathy D. Schleck, Alan R. Zinsmeister, William J. Sandborn. (2004) The safety profile of infliximab in patients with Crohn’s disease: The Mayo Clinic experience in 500 patients. Gastroenterology 126:1, 19-31
CrossRef98
William J Sandborn, Victor W Fazio, Brian G Feagan, Stephen B Hanauer. (2003) AGA technical review on perianal Crohn’s disease. Gastroenterology 125:5, 1508-1530
CrossRef99
T.P. Sullivan, E. Welsh, F.A. Kerdel, A.E. Burdick, R.S. Kirsner. (2003) Infliximab for hidradenitis suppurativa. British Journal of Dermatology 149:5, 1046-1049
CrossRef100
Todd Ellerin, Robert H. Rubin, Michael E. Weinblatt. (2003) Infections and anti-tumor necrosis factor ? therapy. Arthritis & Rheumatism 48:11, 3013-3022
CrossRef101
Ian K Campbell, Lynden J Roberts, Ian P Wicks. (2003) Molecular targets in immune-mediated diseases: the case of tumour necrosis factor and rheumatoid arthritis. Immunology and Cell Biology 81:5, 354-366
CrossRef102
Geoffrey S. Gottlieb, Cammie F. Lesser, King K. Holmes, Anna Wald. (2003) Disseminated Sporotrichosis Associated with Treatment with Immunosuppressants and Tumor Necrosis Factor–α Antagonists. Clinical Infectious Diseases 37:6, 838-840
CrossRef103
Daniel G. Remick, Gerald E. Bolgos, Javed Siddiqui. (2003) Inflammatory status in sepsis alters efficacy of interleukin-18 binding protein therapy*. Critical Care Medicine 31:8, 2096-2101
CrossRef104
Francesco G. De Rosa, David Shaz, Anthony C. Campagna, Paul F. Dellaripa, Urmila Khettry, Donald E. Craven. (2003) Invasive Pulmonary Aspergillosis Soon After Therapy With Infliximab, a Tumor Necrosis Factor‐Alpha‐Neutralizing Antibody: A Possible Healthcare‐Associated Case? • . Infection Control and Hospital Epidemiology 24:7, 477-482
CrossRef105
Mihai G. Netea, Timothy Radstake, Leo A. Joosten, Jos W. M. van der Meer, Pilar Barrera, Bart Jan Kullberg. (2003) Salmonella septicemia in rheumatoid arthritis patients receiving anti-tumor necrosis factor therapy: Association with decreased interferon-? production and toll-like receptor 4 expression. Arthritis & Rheumatism 48:7, 1853-1857
CrossRef106
Aparna K. Mohan, Timothy R. Coté, Jeffrey N. Siegel, Miles M. Braun. (2003) Infectious complications of biologic treatments of rheumatoid arthritis. Current Opinion in Rheumatology 15:3, 179-184
CrossRef107
JC Prinz. (2003) The role of T cells in psoriasis. Journal of the European Academy of Dermatology and Venereology 17:3, 257-270
CrossRef108
Emmanuel Roilides, Joseph Meletiadis. (2003) Role of cytokines against invasive aspergillosis. Reviews in Medical Microbiology 14:2, 63-72
CrossRef109
Ian Storch, David Sachar, Seymour Katz. (2003) Pulmonary Manifestations of Inflammatory Bowel Disease. Inflammatory Bowel Diseases 9:2, 104-115
CrossRef110
William J Sandborn. (2003) Strategies for targeting tumour necrosis factor in IBD. Best Practice & Research Clinical Gastroenterology 17:1, 105-117
CrossRef111
Jason C Gallagher, Elizabeth S Dodds Ashley, Richard H Drew, John R Perfect. (2003) Antifungal pharmacotherapy for invasive mould infections. Expert Opinion on Pharmacotherapy 4:2, 147-164
CrossRef112
Barry Bresnihan, Gaye Cunnane. (2003) Infection complications associated with the use of biologic agents. Rheumatic Disease Clinics of North America 29:1, 185-202
CrossRef113
Nancy R. Slifman, Sharon K. Gershon, Jong-Hoon Lee, Evelyne T. Edwards, M. Miles Braun. (2003) Listeria monocytogenes infection as a complication of treatment with tumor necrosis factor ?-neutralizing agents. Arthritis & Rheumatism 48:2, 319-324
CrossRef114
Rogier J.L Stuyt, Soo-Hyun Kim, Leonid L Reznikov, Giamila Fantuzzi, Daniela Novick, Menachem Rubinstein, Bart Jan Kullberg, Jos W.M van der Meer, Charles A Dinarello, Mihai G Netea. (2003) Regulation of Staphylococcus epidermidis-induced IFN-γ in whole human blood: the role of endogenous IL-18, IL-12, IL-1, and TNF. Cytokine 21:2, 65-73
CrossRef115
Chinyu Su, Bruce A. Salzberg, James D. Lewis, Julius J. Deren, Asher Kornbluth, David A. Katzka, Robert B. Stein, Douglas R. Adler, Gary R. Lichtenstein. (2002) Efficacy of anti-tumor necrosis factor therapy in patients with ulcerative colitis. The American Journal of Gastroenterology 97:10, 2577-2584
CrossRef116
Arthur Kaser, Herbert Tilg. (2002) Antitumour necrosis factor therapy in Crohn’s disease. Expert Opinion on Biological Therapy 2:7, 715-721
CrossRef117
T. Gl
CrossRef118
William J. Sandborn, Stephan R. Targan. (2002) Biologic therapy of inflammatory bowel disease. Gastroenterology 122:6, 1592-1608
CrossRef119
T. Vial, G. Choquet-Kastylevsky, J. Descotes. (2002) Adverse effects of immunotherapeutics involving the immune system. Toxicology 174:1, 3-11
CrossRef120
Douglas L. Riegert-Johnson, John A. Godfrey, Jeffrey L. Myers, Rolf D. Hubmayr, William J. Sandborn, Edward V. Loftus. (2002) Delayed Hypersensitivity Reaction and Acute Respiratory Distress Syndrome Following Infliximab Infusion. Inflammatory Bowel Diseases 8:3, 186-191
CrossRef121
Bruce Beutler. (2002) Endotoxin antagonism: conceptual basis and therapeutic potential. Expert Opinion on Therapeutic Targets 6:2, 147-158
CrossRef122
Melanie W. Pound, Richard H. Drew, John R. Perfect. (2002) Recent advances in the epidemiology, prevention, diagnosis, and treatment of fungal pneumonia. Current Opinion in Infectious Diseases 15:2, 183-194
CrossRef123
Binita M. Kamath, Petar Mamula, Robert N. Baldassano, Jonathan E. Markowitz. (2002) Listeria Meningitis After Treatment With Infliximab. Journal of Pediatric Gastroenterology and Nutrition 34:4, 410-412
CrossRef124
S Roth, E Delmont, P Heudier, R Kaphan, E Cua, J Castela, J.M Verdier, R.M Chichmanian, J.G Fuzibet. (2002) Anticorps anti-TNFα (infliximab) et tuberculose :à propos de trois cas. La Revue de Médecine Interne 23:3, 312-316
CrossRef125
Keane, Joseph, Gershon, Sharon, Wise, Robert P., Mirabile-Levens, Elizabeth, Kasznica, John, Schwieterman, William D., Siegel, Jeffrey N., Braun, M. Miles, . (2001) Tuberculosis Associated with Infliximab, a Tumor Necrosis Factor α–Neutralizing Agent. New England Journal of Medicine 345:15, 1098-1104
Full Text126
&NA;. (2001) Infliximab. Reactions Weekly &NA;:847, 6
CrossRef
