Table 1.
Monoclonal antibodies presented in the current review and their associated infection complications.
| Mab | Target | Main FDA-approved indications | Relative risk for infection | Predominant infection susceptibility |
|---|---|---|---|---|
| Infliximab Adalimumab Etanercept* |
TNF-α | Psoriasis, rheumatoid arthritis, ankylosing spondylitis, inflammatory bowel disease | High | Mycobacterial infections (including disseminated TB) > endemic fungal infections |
| Tocilizumab | IL-6 receptor | Rheumatoid arthritis, CRS during CAR T-cell therapy | Low (short-term exposures) Intermediate (prolonged administration) |
Bacterial infections |
| Brodalumab Ixekizumab Secukinumab Bimekizumab Ustekinumab Risankizumab Tildrakizumab Guselkumab |
IL-17RA IL-17A IL-17A IL-17A/F IL-12p40 IL-23p19 IL-23p19 IL-23p19 |
Psoriasis, inflammatory bowel disease | Low | Mucosal candidiasis (2–4%) |
| Emapalumab | IFN-γ | Hemophagocytic lymphohistiocytosis |
High | Viral > bacterial > fungal infections (overall frequency, 32%) |
| Alemtuzumab | CD52 | Chronic lymphocytic leukemia, multiple sclerosis | High | Herpetic infections, bacterial pneumonia, CMV reactivation in SOT recipients (common) > mucosal candidiasis and other AIDS-defining opportunistic infections |
| Basiliximab | CD20 | Prophylaxis against organ rejection during kidney transplantation | Intermediate | Bacterial infections, CMV reactivation |
| Rituximab | CD20 | Chronic lymphocytic leukemia, lymphomas, rheumatoid arthritis | High | Bacterial and viral infections (common); hepatitis B reactivation (common in HBsAg positive or HBsAg negative/anti-HBc positive individuals); PML (~1:40,000) |
| Daratumumab | CD38 | Multiple myeloma | High | Bacterial and viral infections |
| Natalizumab | α4 integrin | Multiple sclerosis, inflammatory bowel disease | Intermediate | PML (~1:250) |
| Eculizumab | C5a | Hemolytic syndromes | HIgh | Meningococcal infections, pneumococcal infections; Haemophilus infections (common); invasive fungal disease (in patients with additional risk factors) |
| Pembrolizumab | PD-1 | Several malignancies | Low | TB |
*
etanercept is a soluble TNF-α receptor, listed here together with the TNF- α targeting Mabs.
Mab, monoclonal antibody; CAR, chimeric antigen receptor; CRS, cytokine release syndrome, CMV, cytomegalovirus; SOT, solid organ transplantation; TB, tuberculosis, PML, progressive multifocal leukoencephalopathy.