Among the listed risks of TNF inhibitors, which is not listed?

• A. Increased infection risk
• B. Lymphoma risk
• C. Antibody production with ANA
• D. Hypertension

Answer: (D)

TNF inhibitors change how the immune system functions in ways that are best understood by their effects on infections, autoimmunity, and malignancy signals. Blocking TNF-α impairs the body’s ability to mount certain protective inflammatory responses, especially those needed to control intracellular pathogens, so the risk of serious infections is a well-recognized concern with these drugs. There is also evidence suggesting a small, therapy-related signal for lymphoma, reflected in discussions of malignancy risk with long-term immunosuppression in inflammatory diseases. Additionally, TNF inhibitors can trigger autoantibody production, including ANA, and in some cases a lupus-like syndrome, which is why antibody formation is listed among the potential risks.

Hypertension, on the other hand, is not a commonly described or listed adverse effect directly linked to TNF inhibitors. While blood pressure can be influenced by other medications used in rheumatology (for example, steroids or NSAIDs) or by the underlying disease activity, hypertension itself is not a typical or documented risk associated with TNF-blocking therapy.