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Tumor necrosis factor α (TNF-α) blocking agents have been proved to be very effective in the treatment of various inflammatory rheumatic diseases which are refractory to conventional disease-modifying antirheumatic drugs. However, anti-TNF-α therapy may have adverse effects on host defence against infectious agents in which TNF-α plays a pivotal role. In addition, there are reports about neurologic, autoimmune, cardiac, and malignant diseases associated with TNF-α blocking agents. This article summarizes the adverse effects and safety of these agents.