Sudden Death in a Patient Without Heart Failure After a Single Infusion of 200 mg Infliximab: Does TNF-α Have Protective Effects on the Failing Heart, or Does Infliximab Have Direct Harmful Cardiovascular Effects?

Interleukins in Atherosclerosis: Molecular Pathways and Therapeutic Potential

“…Despite encouraging results in early clinical studies, in which subcutaneous etanercept administration appeared to be safe and to result in improvement of cardiac function in patients with advanced heart failure (Bozkurt et al, 2001), a large-scale phase II/III trial (RENEWAL) has recently been prematurely discontinued due to a lack of benefit (Louis et al, 2001). The introduction of infliximab as a therapy for rheumatoid arthritis, on the other hand, has been marred by the recent report of a case of sudden death in a patient without heart failure following a single 200 mg infusion (de' Clari et al, 2002). Moreover, a phase II clinical trial investigating the use of infliximab in advanced congestive heart failure has been placed on hold after the death of seven patients in the treatment group.…”

Update of tnf-alpha antagonists and cardiovascular disease in rheumatoid arthritis

“…Other reports have warned of more serious events. An early report described the somewhat mysterious death of a 64-year old Italian man, 18 hours after his first infusion of infliximab [36]. The patient's RA symptoms seemed to improve after the infusion, but he died the next morning as preparations for discharge from the hospital were made.…”

Atherosclerotic cardiovascular disease in rheumatoid arthritis

“…Thus, these drugs may be contraindicated in patients with underlying heart failure. Even more concerning was a case report from Italy published in 2002 describing sudden unexpected death in a patients with RA after a single infusion of 200 mg infliximab [79]. This information should serve to draw rheumatologists' attention to the possibility of untoward cardiac effects in patients who receive anti-TNFα agents.…”