Tuberculosis infection in rheumatological patients receiving tumor necrosis factor – alpha inhibitors

Genetically engineered biological therapy has been widely introduced in the treatment of rheumatic diseases, lasting for decades until stable remission is achieved. Inhibitors of tumor necrosis factor alpha (TNF-α), a key cytokine, or its receptors are used to block autoimmune inflammation.Interruption of cytokine cascade reactions can lead to defects in immune defense, inadequacy of new or destabilization of previously existing granulomas, and development of tuberculosis infection. Without screening procedures, the risks of tuberculosis increase significantly. In this regard, regular phthisiatric support is required for the entire period of therapy with TNF-α inhibitors.The review examines in detail the role of TNF-α in the immunological response to tuberculosis, the effect of drugs that block this cytokine, the risks of developing tuberculosis when taking them in patients with rheumatological pathology, and the possibilities of reducing this risk through screening, monitoring, and preventive therapy.