title: Paradoxical immune-mediated inflammation in inflammatory bowel disease patients receiving anti-TNF-α agents.
abstract: Reports of autoimmune diseases, including psoriasis- and dermatitis-like skin reactions with anti-tumor necrosis factor-α (TNF-α), are increasing, likely a reflection of the growing use of these agents. This paradoxical phenomenon can no longer be considered rare, with some studies providing incidence estimates of greater than 10%. This paradoxical inflammation has been reported in patients receiving treatment with anti-TNF-α agents for a variety of inflammatory conditions, including inflammatory bowel disease, psoriasis and rheumatoid arthritis and appears to be a class effect. Moreover, there have recently been reports of autoimmune arthralgia occurring in patients receiving anti-TNF-α agents. Further studies are necessary to determine the true incidence of this phenomenon and to identify those patients most likely to be at risk.
authors.affiliation: IBD Center, IRCCS Istituto Clinico Humanitas, Rozzano, Milan, Italy.
authors.forename: Gionata
authors.initials: G
authors.lastname: Fiorino
authors.forename: Silvio
authors.initials: S
authors.lastname: Danese
authors.forename: Benjamin
authors.initials: B
authors.lastname: Pariente
authors.forename: Matthieu
authors.initials: M
authors.lastname: Allez
mesh_terms: D000818:Animals; D000893:Anti-Inflammatory Agents / Q000009:adverse effects* / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D018836:Inflammation Mediators / Q000276:immunology; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy* / Q000276:immunology; D011565:Psoriasis / Q000139:chemically induced*; D014409:Tumor Necrosis Factor-alpha / Q000276:immunology*
chemical_list: D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D018836:Inflammation Mediators; D014409:Tumor Necrosis Factor-alpha
keywords: Anti-TNF; Autoimmunity; IBD; Paradoxical reactions