Case Reports of Heart Failure after Therapy with a Tumor Necrosis Factor Antagonist

Abstract

Etanercept and infliximab are U.S. Food and Drug Administrationapproved tumor necrosis factor (TNF) antagonists. To describe adverse event reports of heart failure after TNF antagonist therapy. Case series. The U.S. Food and Drug Administration's MedWatch program. 47 patients who developed new or worsening heart failure during TNF antagonist therapy. Clinical and laboratory reports. After TNF antagonist therapy, 38 patients developed new-onset heart failure and 9 patients experienced heart failure exacerbation. Of the 38 patients with new-onset heart failure, 19 (50%) had no identifiable risk factors. Ten patients younger than 50 years of age developed new-onset heart failure after receiving TNF antagonists. After TNF antagonist therapy was discontinued and heart failure therapy was started in these 10 patients, 3 had complete resolution of heart failure, 6 improved, and 1 died. In a fraction of patients, TNF antagonists might induce new-onset heart failure or exacerbate existing disease.