Fatal exacerbation of rheumatoid arthritis associated fibrosing alveolitis in patients given infliximab

Tumour necrosis factor α (TNFα) antibodies are increasingly used to treat autoimmune conditions. However, their long term safety is unclear. We report three cases of patients who developed rapid fatal exacerbations of rheumatoid arthritis associated fibrosing alveolitis after taking infliximab (a chimeric monoclonal anti-TNFα antibody; Remicade, Schering-Plough). Each patient had longstanding rheumatoid arthritis, was taking azathioprine, and had previously been diagnosed as having asymptomatic fibrosing alveolitis. …