Inflammatory Bowel Disease as a Paradoxical Reaction to Anti-TNF-α Treatment—A Review
TNF-α inhibitors (TNFis) have revolutionized the treatment of certain chronic immune-mediated diseases, being widely and successfully used in rheumatic inflammatory diseases, and have also proved their efficacy in the treatment of inflammatory bowel disease (IBD). However, among the side effects of...
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MDPI AG
2023-08-01
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| Series: | Life |
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| Online Access: | https://www.mdpi.com/2075-1729/13/8/1779 |
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| author | Ioana Ruxandra Mihai Alexandra Maria Burlui Ioana Irina Rezus Cătălina Mihai Luana Andreea Macovei Anca Cardoneanu Otilia Gavrilescu Mihaela Dranga Elena Rezus |
| author_facet | Ioana Ruxandra Mihai Alexandra Maria Burlui Ioana Irina Rezus Cătălina Mihai Luana Andreea Macovei Anca Cardoneanu Otilia Gavrilescu Mihaela Dranga Elena Rezus |
| author_sort | Ioana Ruxandra Mihai |
| collection | DOAJ |
| description | TNF-α inhibitors (TNFis) have revolutionized the treatment of certain chronic immune-mediated diseases, being widely and successfully used in rheumatic inflammatory diseases, and have also proved their efficacy in the treatment of inflammatory bowel disease (IBD). However, among the side effects of these agents are the so-called paradoxical effects. They can be defined as the appearance or exacerbation of a pathological condition that usually responds to this class of drug while treating a patient for another condition. A wide range of paradoxical effects have been reported including dermatological, intestinal and ophthalmic conditions. The causal mechanism of occurrence may implicate an imbalance of cytokines, but is still not fully understood, and remains a matter of debate. These paradoxical reactions often show improvement on discontinuation of the medication or on switching to another TNFi, but in some cases it is a class effect that could lead to the withdrawal of all anti-TNF agents. Close monitoring of patients treated with TNFis is necessary in order to detect paradoxical reactions. In this study we focus on reviewing IBD occurrence as a paradoxical effect of TNFi therapy in patients with rheumatological diseases (rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, and juvenile idiopathic arthritis). |
| first_indexed | 2024-03-10T23:48:02Z |
| format | Article |
| id | doaj.art-f7375dbf04ed45faa568d2e22ad9dd78 |
| institution | Directory Open Access Journal |
| issn | 2075-1729 |
| language | English |
| last_indexed | 2024-03-10T23:48:02Z |
| publishDate | 2023-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Life |
| spelling | doaj.art-f7375dbf04ed45faa568d2e22ad9dd782023-11-19T01:55:35ZengMDPI AGLife2075-17292023-08-01138177910.3390/life13081779Inflammatory Bowel Disease as a Paradoxical Reaction to Anti-TNF-α Treatment—A ReviewIoana Ruxandra Mihai0Alexandra Maria Burlui1Ioana Irina Rezus2Cătălina Mihai3Luana Andreea Macovei4Anca Cardoneanu5Otilia Gavrilescu6Mihaela Dranga7Elena Rezus8Department of Rheumatology and Rehabilitation, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, RomaniaDepartment of Rheumatology and Rehabilitation, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, RomaniaDepartment of Dermatovenerology, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, RomaniaDepartment of Gastroenterology, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, RomaniaDepartment of Rheumatology and Rehabilitation, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, RomaniaDepartment of Rheumatology and Rehabilitation, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, RomaniaDepartment of Gastroenterology, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, RomaniaDepartment of Gastroenterology, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, RomaniaDepartment of Rheumatology and Rehabilitation, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, RomaniaTNF-α inhibitors (TNFis) have revolutionized the treatment of certain chronic immune-mediated diseases, being widely and successfully used in rheumatic inflammatory diseases, and have also proved their efficacy in the treatment of inflammatory bowel disease (IBD). However, among the side effects of these agents are the so-called paradoxical effects. They can be defined as the appearance or exacerbation of a pathological condition that usually responds to this class of drug while treating a patient for another condition. A wide range of paradoxical effects have been reported including dermatological, intestinal and ophthalmic conditions. The causal mechanism of occurrence may implicate an imbalance of cytokines, but is still not fully understood, and remains a matter of debate. These paradoxical reactions often show improvement on discontinuation of the medication or on switching to another TNFi, but in some cases it is a class effect that could lead to the withdrawal of all anti-TNF agents. Close monitoring of patients treated with TNFis is necessary in order to detect paradoxical reactions. In this study we focus on reviewing IBD occurrence as a paradoxical effect of TNFi therapy in patients with rheumatological diseases (rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, and juvenile idiopathic arthritis).https://www.mdpi.com/2075-1729/13/8/1779paradoxical reactionanti-TNF-αinflammatory bowel diseaseCrohn’s diseaseulcerative colitisbiologic therapy |
| spellingShingle | Ioana Ruxandra Mihai Alexandra Maria Burlui Ioana Irina Rezus Cătălina Mihai Luana Andreea Macovei Anca Cardoneanu Otilia Gavrilescu Mihaela Dranga Elena Rezus Inflammatory Bowel Disease as a Paradoxical Reaction to Anti-TNF-α Treatment—A Review Life paradoxical reaction anti-TNF-α inflammatory bowel disease Crohn’s disease ulcerative colitis biologic therapy |
| title | Inflammatory Bowel Disease as a Paradoxical Reaction to Anti-TNF-α Treatment—A Review |
| title_full | Inflammatory Bowel Disease as a Paradoxical Reaction to Anti-TNF-α Treatment—A Review |
| title_fullStr | Inflammatory Bowel Disease as a Paradoxical Reaction to Anti-TNF-α Treatment—A Review |
| title_full_unstemmed | Inflammatory Bowel Disease as a Paradoxical Reaction to Anti-TNF-α Treatment—A Review |
| title_short | Inflammatory Bowel Disease as a Paradoxical Reaction to Anti-TNF-α Treatment—A Review |
| title_sort | inflammatory bowel disease as a paradoxical reaction to anti tnf α treatment a review |
| topic | paradoxical reaction anti-TNF-α inflammatory bowel disease Crohn’s disease ulcerative colitis biologic therapy |
| url | https://www.mdpi.com/2075-1729/13/8/1779 |
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