0
Sign In  | Subscribe
20 May 2003, Vol 138, No. 10>
Summaries for Patients | 20 May 2003

Tumor Necrosis Factor Antagonists and Heart Failure FREE

[+] Article and Author Information

The summary below is from the full report titled “Case Reports of Heart Failure after Therapy with a Tumor Necrosis Factor Antagonist.” It is in the 20 May 2003 issue of Annals of Internal Medicine (volume 138, pages 807-811). The authors are H.J. Kwon, T.R. Coté, M.S. Cuffe, J.M. Kramer, and M.M. Braun.


Ann Intern Med. 2003;138(10):I-48. doi:10.7326/0003-4819-138-10-200305200-00004
Text Size: A A A

What is the problem and what is known about it so far?

Heart failure is a condition in which the heart does not pump blood as well as it should, leading to fluid building up in the lungs. Old age, high blood pressure, and coronary artery disease are risk factors for heart failure. Drugs called tumor necrosis factor (TNF) antagonists were once thought to offer hope as a treatment for heart failure, but recent studies showed no benefit and one study actually showed that they could worsen heart failure. These drugs have been approved by the U.S. Food and Drug Administration (FDA) for the treatment of two other conditions, inflammatory bowel disease and rheumatoid arthritis.

Why did the researchers do this particular study?

To find out about patients who had heart failure as a complication when they took TNF antagonists to treat inflammatory bowel disease or rheumatoid arthritis.

Who was studied?

47 patients who developed heart failure while taking TNF antagonists to treat inflammatory bowel disease or rheumatoid arthritis. Health care providers and consumers reported the heart failure complications to the FDA.

How was the study done?

The researchers examined the information in the reports. They looked at whether the patients had had heart failure before taking TNF antagonists and had any conditions that put them at risk for heart failure. Risk factors for heart failure include older age, high blood pressure, and other types of heart or lung disease.

What did the researchers find?

Of the 47 patients who developed symptoms of heart failure while taking TNF antagonists, 9 had had problems with heart failure before starting the drugs. The other 38 developed their first episode of heart failure while taking TNF antagonists. Of these 38, 19 had no risk factors for heart failure. In addition, 10 patients were younger than 50 years of age. When these 10 patients stopped taking the TNF antagonists, the heart failure went away completely in 3 and improved in 6; the remaining patient died.

What were the limitations of the study?

The study was based only on cases that were voluntarily reported to the FDA. There may have been additional cases that nobody reported, so this study does not tell us how frequently this complication occurs.

What are the implications of the study?

Doctors and patients should watch for symptoms of heart failure when using TNF antagonists to treat inflammatory bowel disease or rheumatoid arthritis.

Figures

Tables

References

Letters

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Compression-Only CPR: Pushing the Science Forward
Cone
AAM 2010;304:1493-1495.
All you need to read in the other general jounals
BMJ 2010;341:c5893-c1494.

Comments

Submit a Comment
Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

Toolkit

Buy This Article

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Register Now for a free account
Advertisement

Related Content

Customize your page view by dragging & repositioning the boxes below.

In the Clinic
Heart Failure With Preserved Ejection Fraction (Diastolic Dysfunction)
Ann Intern Med. 2013;158(1):ITC1-1.
Heart Failure
Ann Intern Med. 2010;152(11):ITC6-1.
Heart Failure
Ann Intern Med. 2007;147(11):ITC12-1.
Topic Collections
PubMed Articles
Harms of TNF inhibitors in rheumatic diseases: a focused review of the literature.
Immunotherapy Issue date: 2013 Mar
Improvement in safety monitoring of biologic response modifiers after the implementation of clinical care guidelines by a specialty.
Journal of managed care pharmacy : JMCP Issue date: 2013 Jan-Feb

Annals of Internal Medicine

Other Resources

Copyright © 2013 The American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704

Buy This Article

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Register Now for a free account
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.
(Required)
(Required)