<unk>  has adverse effects, some life-threatening, common to drugs in the class of TNF inhibiting immunosuppressants (which also includes etanercept (Enbrel) and adalimumab (Humira)). Some of the most severe are: * serious infections * reactivation of hepatitis B * reactivation of tuberculosis * lethal hepatosplenic T-cell lymphoma (generally only when combined with 6-mercaptopurine) * drug-induced lupus * demyelinating central nervous system disorders * psoriasis and psoriasiform skin lesions * new-onset vitiligo Cases of leukopenia, neutropenia, thrombocytopenia, and pancytopenia (some fatal) have been reported with<unk> . The FDA issued a warning to doctors appearing in the respective product labeling of<unk>  instructing them to screen and monitor potential patients more carefully. The FDA issued a warning to doctors that there is an increased risk of lymphoma and other cancers associated with the use of<unk>  and other tumor necrosis factor blockers in children and adolescents. Maintenance therapy with the drug (versus intermittent or sporadic therapy) lessens the likelihood of developing antibodies to<unk>  which are known to reduce the efficacy of the drug. Combination treatment with methotrexate (an antifolate drug which suppresses the immune system) has been shown to reduce the formation of these antibodies in patients with rheumatoid arthritis and combination therapy with other immunosuppressants has been shown to reduce the likelihood of these antibodies being formed in Crohn's disease. The use of immunosuppressants may not be necessary in all diseases for which<unk>  is indicated, and indiscriminant uses of these other immunosuppressants carry their own risks.<unk>  was studied in monotherapy (without concomitant immunosuppressants such as methotrexate or azathioprine) in psoriasis, psoriatic arthritis, and ankylosing spondylitis. Only its use in rheumatoid arthritis requires the concomitant use of methotrexate by the U.S. Food and Drug Administration (FDA) product labeling; however, the concomitant use of methotrexate in other disease states may help to reduce the body's immune response to the<unk>  and increase its duration of efficacy.
Infliximab
Anakinra
Canakinumab
Belatacept
Vedolizumab
Avelumab
Mepolizumab
Sarilumab