TNF-α is a cytokine involved in the inflammatory response to infection
Has soluble and transmembrane forms
Produced by macrophages, NK cells, granulocytes, fibroblasts, and T cells
Receptors for TNF-α (TNFR1 and TNFR2) are found on most human cells, and are involved in cell activation and proliferation, cytokine production, and granuloma formation
Active bacterial infection, active tuberculosis or untreated LTBI, active herpes zoster infection, active invasive fungal infection, infected skin ulcers, acute hepatitis B or C, untreated chronic hepatitis B, or chronic hepatitis B or C with Child-Pugh B or C
Safety
Baseline TST, ±CXR, prior to starting medications, with patients identified as having LTBI being offered prophylaxis
