Drug of the week- Day 3

A patient is planned to start infliximab therapy for severe ulcerative colitis. Before initiating treatment, the physician orders a Mantoux test and chest X-ray.

:red_question_mark: Why is tuberculosis screening essential before starting infliximab?

:radio_button: A. Infliximab directly damages lung tissue
:radio_button: B. TNF-Ξ± inhibition can reactivate latent TB
:radio_button: C. The drug decreases oxygen exchange
:radio_button: D. TB reduces infliximab absorption

Can you name ANY other serious adverse effect or contraindication associated with infliximab therapy?

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Option : B
Mantoux test and chest X- ray is done inorder to find out active or latent TB infection.
In latent TB bodies immune system uses TNF - alpha to build granulomas and these cellular walls trap mycobacterium tuberculosis bacteria.
Since infliximab blocks TNF - Alpha, it dissolves granulomas β†’release of TB bacteria into body and leading to infection.
Active TB found : Infliximab therapy cannot be started and anti TB therapy should be started.
Latent TB found : patient should be on prophylactic anti TB management.

Opt:- (B)
TNF-Ξ± inhibition can reactivate latent TB