Tumor necrosis factor (TNF)-blockers are considered by many to be a miracle breakthrough in arthritis treatment. Although treatment with TNF-blockers such as infliximab (Remicade®), etanercept (Enbrel®), adalimumab (Humira®), and certolizumab (Cimzia®) seems to be effective in improving arthritis-related pain, they are also associated with potentially serious side effects.

Last week, the U.S. Food and Drug Administration (FDA) ordered manufacturers of TNF-blockers to strengthen the existing warnings about the risk for histoplasmosis and other invasive fungal infections. Although the prescribing information for these drugs has always included information about the risk of infections, the FDA is concerned that healthcare professionals may be missing diagnoses of serious fungal infections, leading to treatment delays and an increased risk of death. So far, the FDA has received 240 reports of histoplasmosis, a fungal infection caused by the fungus Histoplasma capsulatum, in patients receiving TNF-blockers.

Fever, fatigue, weight loss, cough, shortness of breath, and serious illness that does not respond to antibiotics can all be signs of an invasive fungal infection. If you are taking a TNF-blocker and are experiencing these symptoms, considering seeing your doctor for a work-up.