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Adverse reactions to biological modifiers

Purpose of reviewNewer biologic immunomodulators such as interferons, tumor necrosis factor α (TNFα) inhibitors, and monoclonal antibodies have been introduced into the management of various inflammatory conditions. This review addresses adverse responses to these agents. Recent findingsBoth interferon-α and interferon-β have been associated with autoimmune phenomena. The ability of TNFα antagonists to cause significant adverse reactions appears to be substantial. These are either related to interference with TNFα activity or as consequence of the agents, either immunoglobulin or fusion protein, being recognized as foreign proteins, becoming themselves targets of an immune response. SummaryAlthough advancing the management of inflammatory conditions, biologic modifiers are attended by significant concerns. Identification of at risk groups and careful selection of appropriate patients will minimize occurrence of adverse events.