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.