Anti-TNF therapies (a type of biologic therapy)
Anti-TNF (anti-tumour necrosis factor) therapies may be prescribed to people with severe active AS (by their rheumatologist) if other therapies have failed or are unsuitable.
These therapies target part of the immune system that is responsible for causing an excessive inflammatory response in AS, they act by re-balancing this response.
There are a number of available anti-TNF therapies used to treat AS. If these are prescribed, a healthcare professional will discuss the different options available to help find the best therapy for you. The healthcare professional will also give you information about the benefits and side effects and discuss any increased risks associated with the different anti-TNF therapies available.
Anti-TNF therapies are taken either by subcutaneous injection (an injection just under the skin) or by intravenous infusion (via a needle into a vein). Taking anti-TNF therapy can help to improve AS symptoms such as:
- Joint pain and stiffness
- Joint swelling and flexibility
- Fatigue
The most common side effect of these therapies is a reaction at the site where the injection or infusion is given e.g. redness, swelling or infection etc. Some people can also experience an allergic reaction at the beginning of treatment and may be given other medication to reduce this effect. Because anti-TNF therapies act on the immune system you could be more likely to get an infection while on this treatment and even for some months after stopping it.
Your doctor or nurse will screen you for any risk factors prior to starting you on this medication. You will have blood tests and these will be repeated at regular intervals while you receive this treatment.
Full details of potential side effects are available in the patient information leaflets for these medications.
ANYONE TAKING THIS GROUP OF MEDICATIONS WILL BE PROVIDED WITH A PATIENT ALERT CARD, TO BE CARRIED AT ALL TIMES. THIS PROVIDES IMPORTANT INFORMATION ABOUT YOUR ANTI-TNF. IT SHOUD BE SHOWN TO ANY HEALTHCARE PROFESSIONAL YOU SEEK MEDICAL ASSISTANCE FROM.
1. Anti-TNF therapy by subcutaneous injection
There are a variety of products available given as a subcutaneous injection (an injection given just under the skin) and they come in different forms such as an auto-injector pen, a pre-filled syringe, or as a powder which is mixed with a solution and then injected. Your healthcare professional will tell you about the administration of your treatment and then you may be able to give yourself the injections at home or with the help of a carer. It depends which anti-TNF therapy is being taken as to how often the medication is needed.
Some people may have an allergic reaction to anti-TNF therapies, although serious allergic reactions are rare. If any of the following symptoms are experienced following the injection, you should seek urgent medical attention:
- Trouble swallowing or breathing
- Swelling of the face, throat, hands or feet
- Feeling nervous or anxious, throbbing sensations, severe reddening of the skin
- Severe rash, itching or hives (raised patches of red or pale skin that often itch)
There may also be potential side effects to taking anti-TNF injections, the most common of which include:
- Injection site reactions e.g. redness, swelling, bleeding, bruising and itching
- Infections
For a full list refer to the patient information leaflet that comes with the medication.
2. Anti-TNF therapy infusions
An infusion is a way of introducing a treatment via a needle directly into a vein. An infusion will be administered in a healthcare setting, such as a hospital, over a set amount of time (normally a couple of hours). A healthcare professional will monitor you while the infusion is received and for one to two hours afterwards.
The doctor will decide how often an infusion is required based on your condition and you have responded to the anti-TNF therapy.
Some patients may develop an allergic reaction during or after the infusion. Your healthcare professional should make you aware of potential side effects. If you experience any of these potential side effects, you should seek urgent medical attention.