TNF–α inhibitors should not be used in :
Anti-TNF α drugs should be avoided in
Pulmonary tuberculosis
Multiple sclerosis
Hepatitis B
Congestive heart failure


Anti -TNF-α drugs like infliximab, etanercept and adalimumab are used in rheumatoid arthritis and increase the risk of bacterial infections. These can lead to reactivation of latent tuberculosis. Infliximab rarely, results in leucopenia, activation of hepatitis B and vasculitis.
Rheumatoid arthritis with HIV infection
Rheumatoid arthritis with hepatitis B
Rheumatoid arthritis with hepatitis C
Rheumatoid arthritis with pulmonary fibrosis