title: Is it safe to use TNF-α blockers for systemic inflammatory disease in patients with heart failure? Importance of dosage and receptor specificity.
abstract: Tumor necrosis factor-alpha (TNF-α) blockers are widely used in the treatment of chronic inflammatory diseases, especially chronic arthritis. Current guidelines advise against the use of such agents in patients who have a concomitant heart failure. Consequently, a group of patients with a devastating inflammatory disease cannot benefit from an excellent treatment option. After a critical review of the current literature, we conclude that there is not sufficient evidence to warn against such a regimen if recommended standard doses are used. A negative effect on the heart function seems to occur if unconventional high doses of TNF-α blockers are given. The theoretical background for this is discussed.
authors.affiliation: Department of Rheumatology, Hospital of Southern Norway, Kristiansand, Norway. andreas.diamantopoulos@sshf.no
authors.forename: Andreas P
authors.initials: AP
authors.lastname: Diamantopoulos
authors.forename: Alf I
authors.initials: AI
authors.lastname: Larsen
authors.forename: Roald
authors.initials: R
authors.lastname: Omdal
mesh_terms: D000818:Animals; D001168:Arthritis / Q000188:drug therapy / Q000453:epidemiology / Q000378:metabolism; D004305:Dose-Response Relationship, Drug; D000068800:Etanercept; D006333:Heart Failure / Q000188:drug therapy* / Q000453:epidemiology* / Q000378:metabolism; D006801:Humans; D007074:Immunoglobulin G / Q000008:administration & dosage; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D016032:Randomized Controlled Trials as Topic / Q000379:methods; D018124:Receptors, Tumor Necrosis Factor / Q000008:administration & dosage / Q000037:antagonists & inhibitors* / Q000378:metabolism; D018746:Systemic Inflammatory Response Syndrome / Q000188:drug therapy / Q000453:epidemiology / Q000378:metabolism; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors* / Q000502:physiology
chemical_list: D007074:Immunoglobulin G; D007166:Immunosuppressive Agents; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D000068800:Etanercept