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 also proved their efficacy bowel disease (IBD). However, among side effects these agents are so-called paradoxical effects. They can be defined as appearance or exacerbation a pathological condition that usually responds to this class drug while treating patient for another condition. A wide range been reported including dermatological, intestinal ophthalmic conditions. The causal mechanism occurrence may implicate an imbalance cytokines, but is still not fully understood, remains matter debate. These reactions often show improvement on discontinuation medication switching TNFi, some cases it effect could lead withdrawal all anti-TNF agents. Close monitoring patients treated with TNFis necessary order detect reactions. In study we focus reviewing IBD TNFi therapy rheumatological diseases (rheumatoid arthritis, psoriatic ankylosing spondylitis, juvenile idiopathic arthritis).