TNF-Alpha Inhibitors

Key points

• TNF-α inhibitors: infliximab (chimeric monoclonal antibody, IV), adalimumab (fully human, SC), etanercept (fusion protein, SC).
• Uses: rheumatoid arthritis (after DMARD failure), IBD, psoriasis, ankylosing spondylitis.
• Main risks: reactivation of TB (screen before starting), demyelination, worsening heart failure, increased infection risk.
• Avoid in demyelinating disease and significant heart failure.

Decision points in this pathway

• Before starting

The full step-by-step algorithm, including what to do at each branch, opens in the app for approved members.