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Published on: September 12, 2019
Tumor necrosis factor-alpha inhibitor associated ulcerative colitis
Kara Prescott1, Melissa Costner, Stanley Cohen
1Internal Medicine Department, Rheumatic Diseases Division, University of Texas Southwestern Medical Center, Dallas, Texas, USA. kprescott74@yahoo.com
The American Journal of the Medical Sciences
|May 15, 2007
Summary
Tumor necrosis factor-alpha inhibitors may rarely trigger ulcerative colitis flares or new-onset disease in patients with rheumatic conditions. This suggests a potential link between these immunosuppressants and inflammatory bowel disease activity.
Area of Science:
- Rheumatology
- Gastroenterology
- Immunology
Background:
- Inflammatory bowel disease (IBD) flares or onset have been anecdotally linked to immunosuppressive therapies.
- Tumor necrosis factor-alpha (TNF-α) inhibitors are commonly used to manage various autoimmune and inflammatory conditions.
Observation:
- This study examined four patients with rheumatic diseases who experienced ulcerative colitis (UC) onset or flares during TNF-α inhibitor therapy.
- Two patients had pre-existing UC that flared after etanercept initiation, while two developed de novo UC while on TNF-α inhibitors.
Findings:
- A temporal association was observed between initiating TNF-α inhibitor treatment and the onset or exacerbation of ulcerative colitis.
- The observed cases involved patients with seronegative spondyloarthropathy, rheumatoid arthritis, and amyopathic dermatomyositis.
Implications:
- These findings suggest that TNF-α inhibitors, despite their therapeutic use in IBD, may rarely contribute to UC development or flares.
- Further research is warranted to elucidate the mechanisms underlying this potential association and inform clinical practice regarding immunosuppression in rheumatic patients.
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