Anti-tumor necrosis factor therapy in rheumatoid arthritis patients with a history of deep prosthetic joint infection: a report of four cases.

Four rheumatoid arthritis patients (three women and one man) who had a history of prosthetic joint infection were treated with anti-tumor necrosis factor (TNF) agents after treatment of the infection. The anti-TNF therapy was subsequently discontinued in three patients. The reason for discontinuation was not the reactivation of infection, but disseminated tuberculosis, Pneumocystis jiroveci pneumonia, and interstitial pneumonia, respectively. These cases suggest that a history of prosthetic joint infection may be a contraindication for treatment with anti-TNF agents.