Abstract
Anti-TNF antibodies have acquired a prominent place in the management of IBD (including Crohn's disease and ulcerative colitis), rheumatologic conditions (such as rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis) and psoriasis. They have a good safety profile, especially when contraindications such as demyelinating disease, active infections and/or abscesses are ruled out, and when necessary precautions to prevent reactivation of tuberculosis are taken. However, with increasing use of these agents, paradoxical adverse events have been reported. Some of these features are shared with the underlying disease for which these drugs are given, making management of these conditions challenging. For example, anti-TNF therapy is used for the treatment of psoriasis, but psoriasiform lesions are sometimes observed in patients receiving therapy. Similarly, anti-TNF therapy is used for the treatment of rheumatologic diseases, but arthralgias and arthritis are sometimes observed in patients receiving anti-TNF agents. We review the paradoxical inflammation induced by anti-TNF agents in patients with IBD, provide hypotheses for the occurrence of this paradoxical inflammation and give practical advice on how to manage these patients.
Key Points
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Paradoxical adverse effects involving the skin, joints and lungs have been described with all anti-TNF agents
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Skin manifestations are the most common adverse event and occur in 20–25% of patients receiving anti-TNFs
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The outcome for skin manifestations is generally favourable with the implementation of preventive measures and topical therapy
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Paradoxical reactions to anti-TNF agents may necessitate cessation of therapy in 5–10% of patients depending on the underlying reaction and its severity
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The mechanisms by which adverse events to anti-TNF agents occur are not understood and more effort should be made to dissect the underlying pathways
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References
Peyrin-Biroulet, L. Anti-TNF therapy in inflammatory bowel diseases: a huge review. Minerva Gastroenterol. Dietol. 56, 233–243 (2010).
Wiens, A., Venson, R., Correr, C. J., Otuki, M. F. & Pontarolo, R. Meta-analysis of the efficacy and safety of adalimumab, etanercept, and infliximab for the treatment of rheumatoid arthritis. Pharmacotherapy 30, 339–353 (2010).
Reed, M. R. & Taylor, A. L. Tumour necrosis factor inhibitors in ankylosing spondylitis. Intern. Med. J. 38, 781–789 (2008).
Gottlieb, A. B. et al. Infliximab induction therapy for patients with severe plaque-type psoriasis: a randomized, double-blind, placebo-controlled trial. J. Am. Acad. Dermatol. 51, 534–542 (2004).
Mease, P. TNFalpha therapy in psoriatic arthritis and psoriasis. Ann. Rheum. Dis. 63, 755–758 (2004).
Menter, A. The status of biologic therapies in the treatment of moderate to severe psoriasis. Cutis 84, 14–24 (2009).
Papp, K. A. et al. A global phase III randomized controlled trial of etanercept in psoriasis: safety, efficacy, and effect of dose reduction. Br. J. Dermatol. 152, 1304–1312 (2005).
Heldmann, F. et al. The European ankylosing spondylitis infliximab cohort (EASIC): a European multicentre study of long term outcomes in patients with ankylosing spondylitis treated with infliximab. Clin. Exp. Rheumatol. 29, 672–680 (2011).
Mease, P. J. Certolizumab pegol in the treatment of rheumatoid arthritis: a comprehensive review of its clinical efficacy and safety. Rheumatology (Oxford) 50, 261–270 (2011).
Ngo, B. et al. Tumor necrosis factor blockade for treatment of inflammatory bowel disease: efficacy and safety. Curr. Mol. Pharmacol. 3, 145–152 (2010).
Voulgari, P. V. Golimumab: a new anti-TNF-alpha agent for rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis. Expert Rev. Clin. Immunol. 6, 721–733 (2010).
Ramiro, S., van Tubergen, A. M. & Landewe, R. B. RAPID and FAST4WARD trials: certolizumab pegol for rheumatoid arthritis. Expert Rev. Clin. Immunol. 6, 713–720 (2010).
D'Haens, G. et al. Endoscopic and histological healing with infliximab anti-tumor necrosis factor antibodies in Crohn's disease: a European multicenter trial. Gastroenterology 116, 1029–1034 (1999).
Bongartz, T. et al. Anti-TNF antibody therapy in rheumatoid arthritis and the risk of serious infections and malignancies: systematic review and meta-analysis of rare harmful effects in randomized controlled trials. JAMA 295, 2275–2285 (2006).
Fidder, H. H. et al. Long-term safety of infliximab for the treatment of inflammatory bowel disease: a single center cohort study. Gut 58, 501–508 (2009).
Baraliakos, X. et al. Persistent clinical efficacy and safety of infliximab in ankylosing spondylitis after 8 years--early clinical response predicts long-term outcome. Rheumatology (Oxford) 50, 1690–1699 (2011).
Kievit, W. et al. Long-term effectiveness and safety of TNF-blocking agents in daily clinical practice: results from the Dutch Rheumatoid Arthritis Monitoring register. Rheumatology (Oxford) 50, 196–203 (2011).
Komano, Y. et al. Incidence and risk factors for serious infection in patients with rheumatoid arthritis treated with tumor necrosis factor inhibitors: a report from the Registry of Japanese Rheumatoid Arthritis Patients for Longterm Safety. J. Rheumatol. 38, 1258–1264 (2011).
Hoentjen, F. & van Bodegraven, A. A. Safety of anti-tumor necrosis factor therapy in inflammatory bowel disease. World J. Gastroenterol. 15, 2067–2073 (2009).
Kircik, L. H. & Del Rosso, J. Q. Anti-TNF agents for the treatment of psoriasis. J. Drugs Dermatol. 8, 546–559 (2009).
Markatseli, T. E., Alamanos, Y., Saougou, I., Voulgari, P. V. & Drosos, A. A. Survival of TNF-alpha antagonists in rheumatoid arthritis: a long-term study. Clin. Exp. Rheumatol. 30, 31–38 (2012).
Colombel, J. F. et al. Adalimumab safety in global clinical trials of patients with Crohn's disease. Inflamm. Bowel Dis. 15, 1308–1319 (2009).
Adams, D. R., Buckel, T. & Sceppa, J. A. Infliximab associated new-onset psoriasis. J. Drugs Dermatol. 5, 178–179 (2006).
Angelucci, E., Cocco, A., Viscido, A., Vernia, P. & Caprilli, R. Another paradox in Crohn's disease: new onset of psoriasis in a patient receiving tumor necrosis factor-alpha antagonist. Inflamm. Bowel Dis. 13, 1059–1061 (2007).
Cohen, J. D. et al. Psoriasis induced by tumor necrosis factor-alpha antagonist therapy: a case series. J. Rheumatol. 34, 380–385 (2007).
Collamer, A. N., Guerrero, K. T., Henning, J. S. & Battafarano, D. F. Psoriatic skin lesions induced by tumor necrosis factor antagonist therapy: a literature review and potential mechanisms of action. Arthritis Rheum. 59, 996–1001 (2008).
Conklin, L. S., Cohen, B., Wilson, L., Cuffari, C. & Oliva-Hemker, M. Rash induced by anti-tumor necrosis factor agents in an adolescent with Crohn's disease. Nat. Rev. Gastroenterol. Hepatol. 7, 174–177 (2010).
Costa-Romero, M., Coto-Segura, P., Suarez-Saavedra, S., Ramos-Polo, E. & Santos-Juanes, J. Guttate psoriasis induced by infliximab in a child with Crohn's disease. Inflamm. Bowel Dis. 14, 1462–1463 (2008).
English, P. L. & Vender, R. Occurrence of plantar pustular psoriasis during treatment with infliximab. J. Cutan. Med. Surg. 13, 40–42 (2009).
Goldstein, J. & Levine, J. Infliximab-induced psoriaform rash. Clin. Gastroenterol. Hepatol. 8, A24 (2010).
Hiremath, G., Duffy, L. & Leibowitz, I. Infliximab-induced psoriasis in children with inflammatory bowel disease. J. Pediatr. Gastroenterol. Nutr. 52, 230–232 (2011).
Iborra, M., Beltran, B., Bastida, G., Aguas, M. & Nos, P. Infliximab and adalimumab-induced psoriasis in Crohn's disease: a paradoxical side effect. J. Crohns Colitis 5, 157–161 (2011).
Laga, A. C., Vleugels, R. A., Qureshi, A. A. & Velazquez, E. F. Histopathologic spectrum of psoriasiform skin reactions associated with tumor necrosis factor-alpha inhibitor therapy. A study of 16 biopsies. Am. J. Dermatopathol. 32, 568–573 (2010).
Manni, E. & Barachini, P. Psoriasis induced by infliximab in a patient suffering from Crohn's disease. Int. J. Immunopathol. Pharmacol. 22, 841–844 (2009).
Medkour, F. et al. Development of diffuse psoriasis with alopecia during treatment of Crohn's disease with infliximab. Gastroenterol. Clin. Biol. 34, 140–141 (2010).
Papadavid, E., Gazi, S., Dalamaga, M., Stavrianeas, N. & Ntelis, V. Palmoplantar and scalp psoriasis occurring during anti-tumour necrosis factor-alpha therapy: a case series of four patients and guidelines for management. J. Eur. Acad. Dermatol. Venereol. 22, 380–382 (2008).
Park, B. C. et al. Repeated paradoxical aggravation of preexisting psoriasis during infliximab treatment for Crohn's disease. Ann. Dermatol. 21, 60–62 (2009).
Passarini, B. et al. Cutaneous manifestations in inflammatory bowel diseases: eight cases of psoriasis induced by anti-tumor-necrosis-factor antibody therapy. Dermatology 215, 295–300 (2007).
Peramiquel, L. et al. Onset of flexural psoriasis during infliximab treatment for Crohn's disease. Clin. Exp. Dermatol. 30, 713–714 (2005).
Perez-Perez, L., Caeiro, J. L., Fabeiro, J. M., Allegue, F. & Zulaica, A. Induction of pustular lesions during infliximab therapy for Crohn's disease. Acta Derm. Venereol. 88, 292–293 (2008).
Pirard, D., Arco, D., Debrouckere, V. & Heenen, M. Anti-tumor necrosis factor alpha-induced psoriasiform eruptions: three further cases and current overview. Dermatology 213, 182–186 (2006).
Pourciau, C. & Shwayder, T. Occurrence of pustular psoriasis after treatment of Crohn disease with infliximab. Pediatr. Dermatol. 27, 539–540 (2010).
Takahashi, H. et al. Psoriasiform and pustular eruption induced by infliximab. J. Dermatol. 34, 468–472 (2007).
Umeno, J. et al. Psoriasis during anti-tumor necrosis factor-alpha therapy for Crohn's disease. Inflamm. Bowel Dis. 13, 1188–1189 (2007).
Verea, M. M., Del Pozo, J., Yebra-Pimentel, M. T., Porta, A. & Fonseca, E. Psoriasiform eruption induced by infliximab. Ann. Pharmacother. 38, 54–57 (2004).
Wollina, U. et al. Tumor necrosis factor-alpha inhibitor-induced psoriasis or psoriasiform exanthemata: first 120 cases from the literature including a series of six new patients. Am. J. Clin. Dermatol. 9, 1–14 (2008).
Baumgart, D. C., Grittner, U., Steingraber, A., Azzaro, M. & Philipp, S. Frequency, phenotype, outcome, and therapeutic impact of skin reactions following initiation of adalimumab therapy: experience from a consecutive cohort of inflammatory bowel disease patients. Inflamm. Bowel Dis. 17, 2512–2520 (2011).
Cullen, G., Kroshinsky, D., Cheifetz, A. S. & Korzenik, J. R. Psoriasis associated with anti-tumour necrosis factor therapy in inflammatory bowel disease: a new series and a review of 120 cases from the literature. Aliment. Pharmacol. Ther. 34, 1318–1327 (2011).
Ettler, J., Wetter, D. A. & Pittelkow, M. R. Pityriasis amiantacea: a distinctive presentation of psoriasis associated with tumour necrosis factor-alpha inhibitor therapy. Clin. Exp. Dermatol. http://dx.doi.org/10.1111/j.1365-22302011.04286.x.
Klein, R. Q., Spivack, J. & Choate, K. A. Psoriatic skin lesions induced by certolizumab pegol. Arch. Dermatol. 146, 1055–1056 (2010).
Rahier, J. F. et al. Severe skin lesions cause patients with inflammatory bowel disease to discontinue anti-tumor necrosis factor therapy. Clin. Gastroenterol. Hepatol. 8, 1048–1055 (2010).
Cleynen, I. et al. Anti-TNF induced cutaneous lesions in IBD patients: characterization and search for predisposing factors. Gut 59, A1 (2010).
Harrison, M. J. et al. Rates of new-onset psoriasis in patients with rheumatoid arthritis receiving anti-tumour necrosis factor alpha therapy: results from the British Society for Rheumatology Biologics Register. Ann. Rheum. Dis. 68, 209–215 (2009).
Dalkilic, E. et al. Tumor necrosis factor-alpha antagonist therapy-induced psoriasis in Turkey: analysis of 514 patients. Mod. Rheumatol. http://dx.doi.org/10.1007/s10165-011-0590-9.
de Gannes, G. C. et al. Psoriasis and pustular dermatitis triggered by TNF-{alpha} inhibitors in patients with rheumatologic conditions. Arch. Dermatol. 143, 223–231 (2007).
Ko, J. M., Gottlieb, A. B. & Kerbleski, J. F. Induction and exacerbation of psoriasis with TNF-blockade therapy: a review and analysis of 127 cases. J. Dermatolog. Treat. 20, 100–108 (2009).
Perez-Zafrilla, B., Angel Descalzo, M. & Carmona, L. Adverse reactions related to the administration of TNF inhibitors. Analysis of a registry of biologic therapy [Spanish]. Reumatol. Clin. 4, 90–95 (2008).
Beccastrini, E., Squatrito, D., Emmi, G., Fabbri, P. & Emmi, L. Alopecia areata universalis during off-label treatment with infliximab in a patient with Behcet disease. Dermatol. Online J. 16, 15 (2010).
Chaves, Y. et al. Alopecia areata universalis during treatment of rheumatoid arthritis with anti-TNF-alpha antibody (adalimumab). Dermatology 217, 380 (2008).
Doyle, L. A. et al. Psoriatic alopecia/alopecia areata-like reactions secondary to anti-tumor necrosis factor-alpha therapy: a novel cause of noncicatricial alopecia. Am. J. Dermatopathol. 33, 161–166 (2011).
Exarchou, S. A., Voulgari, P. V., Markatseli, T. E., Zioga, A. & Drosos, A. A. Immune-mediated skin lesions in patients treated with anti-tumour necrosis factor alpha inhibitors. Scand. J. Rheumatol. 38, 328–331 (2009).
Ferran, M., Calvet, J., Almirall, M., Pujol, R. M. & Maymo, J. Alopecia areata as another immune-mediated disease developed in patients treated with tumour necrosis factor-alpha blocker agents: report of five cases and review of the literature. J. Eur. Acad. Dermatol. Venereol. 25, 479–484 (2011).
Kirshen, C. & Kanigsberg, N. Alopecia areata following adalimumab. J. Cutan. Med. Surg. 13, 48–50 (2009).
Le Bidre, E. et al. Alopecia areata during anti-TNF alpha therapy: nine cases [French]. Ann. Dermatol. Venereol. 138, 285–293 (2011).
Pan, Y. & Rao, N. A. Alopecia areata during etanercept therapy. Ocul. Immunol. Inflamm. 17, 127–129 (2009).
Pelivani, N., Hassan, A. S., Braathen, L. R., Hunger, R. E. & Yawalkar, N. Alopecia areata universalis elicited during treatment with adalimumab. Dermatology 216, 320–323 (2008).
Fujikawa, K. et al. Cutaneous vasculitis induced by TNF inhibitors: a report of three cases. Mod. Rheumatol. 20, 86–89 (2010).
Ramos-Casals, M., Brito-Zeron, P., Cuadrado, M. J. & Khamashta, M. A. Vasculitis induced by tumor necrosis factor-targeted therapies. Curr. Rheumatol. Rep. 10, 442–448 (2008).
Roux, C. H., Brocq, O., Albert, C. B. V. & Euller-Ziegler, L. Cutaneous vasculitis and glomerulonephritis in a patient taking the anti-TNF alpha agent etanercept for rheumatoid arthritis. Joint Bone Spine 71, 444–445 (2004).
Flendrie, M. et al. Dermatological conditions during TNF-alpha-blocking therapy in patients with rheumatoid arthritis: a prospective study. Arthritis Res. Ther. 7, R666–R676 (2005).
Pontikaki, I. et al. Skin manifestations induced by TNF-alpha inhibitors in juvenile idiopathic arthritis. Clin. Rev. Allergy Immunol. 42, 131–134 (2012).
Vermeire, S. et al. Autoimmunity associated with anti-tumor necrosis factor alpha treatment in Crohn's disease: a prospective cohort study. Gastroenterology 125, 32–39 (2003).
Van Moerkercke, W. et al. Anti-TNFa induced severe arthralgia as a manifestation of autoimmunity? Gastroenterology 138 (Suppl. 61), S60–S61 (2010).
Rozenbaum, M., Boulman, N., Slobodin, G., Ayubkhanov, E. & Rosner, I. Polyarthritis flare complicating rheumatoid arthritis infliximab therapy: a paradoxic adverse reaction. J. Clin. Rheumatol. 12, 269–271 (2006).
Fok, K. C., Ng, W. W., Henderson, C. J. & Connor, S. J. Cutaneous sarcoidosis in a patient with ulcerative colitis on infliximab. J. Crohns Colitis http://dx.doi.org/10.1016/j.crohns.2012.01.008.
Gifre, L. et al. Lung sarcoidosis induced by TNF antagonists in rheumatoid arthritis: a case presentation and a literature review. Arch. Bronconeumol. 47, 208–212 (2011).
Shin, J. I. & Kim, D. S. Development of sarcoidosis during anti-TNF-alpha treatment: what is the mechanism? Clin. Exp. Rheumatol. 27, 1054 (2009).
Tong, D., Manolios, N., Howe, G. & Spencer, D. New onset sarcoid-like granulomatosis developing during anti-TNF therapy: an under-recognised complication. Int. Med. J. 42, 89–94 (2012).
Croft, A. P. et al. Refractory multisystem sarcoidosis responding to infliximab therapy. Clin. Rheumatol. http://dx.doi.org/10.1007/s10067-011-1933-9.
Erckens, R. J., Mostard, R. L., Wijnen, P. A., Schouten, J. S. & Drent, M. Adalimumab successful in sarcoidosis patients with refractory chronic non-infectious uveitis. Graefes Arch. Clin. Exp. Ophthalmol. 250, 713–720 (2012).
Duerr, R. H. et al. A genome-wide association study identifies IL23R as an inflammatory bowel disease gene. Science 314, 1461–1463 (2006).
Garcia, V. E. et al. Detailed genetic characterization of the interleukin-23 receptor in psoriasis. Genes Immun. 9, 546–555 (2008).
Capon, F. et al. Sequence variants in the genes for the interleukin-23 receptor (IL23R) and its ligand (IL12B) confer protection against psoriasis. Hum. Genet. 122, 201–206 (2007).
Cargill, M. et al. A large-scale genetic association study confirms IL12B and leads to the identification of IL23R as psoriasis-risk genes. Am. J. Hum. Genet. 80, 273–290 (2007).
Nair, R. P. et al. Genome-wide scan reveals association of psoriasis with IL-23 and NF-kappaB pathways. Nat. Genet. 41, 199–204 (2009).
Chang, M. et al. Variants in the 5q31 cytokine gene cluster are associated with psoriasis. Genes Immun. 9, 176–181 (2008).
Barrett, J. C. et al. Genome-wide association defines more than 30 distinct susceptibility loci for Crohn's disease. Nat. Genet. 40, 955–962 (2008).
Franke, A. et al. Genome-wide meta-analysis increases to 71 the number of confirmed Crohn's disease susceptibility loci. Nat. Genet. 42, 1118–1125 (2011).
Hugot, J. P. et al. Association of NOD2 leucine-rich repeat variants with susceptibility to Crohn's disease. Nature 411, 599–603 (2001).
Liu, Y. et al. A genome-wide association study of psoriasis and psoriatic arthritis identifies new disease loci. PLoS Genet. 4, e1000041 (2008).
Schrodi, S. J. Genome-wide association scan in psoriasis: new insights into chronic inflammatory disease. Expert Rev. Clin. Immunol. 4, 565–571 (2008).
Morar, N., Cookson, W. O., Harper, J. I. & Moffatt, M. F. Filaggrin mutations in children with severe atopic dermatitis. J. Invest. Dermatol. 127, 1667–1672 (2007).
Palmer, C. N. et al. Common loss-of-function variants of the epidermal barrier protein filaggrin are a major predisposing factor for atopic dermatitis. Nat. Genet. 38, 441–446 (2006).
Duffin, K. C., Woodcock, J. & Krueger, G. G. Genetic variations associated with psoriasis and psoriatic arthritis found by genome-wide association. Dermatol. Ther. 23, 101–113 (2010).
Elder, J. T. Genome-wide association scan yields new insights into the immunopathogenesis of psoriasis. Genes Immun. 10, 201–209 (2009).
de Cid, R. et al. Deletion of the late cornified envelope LCE3B and LCE3C genes as a susceptibility factor for psoriasis. Nat. Genet. 41, 211–215 (2009).
Gershov, D., Kim, S., Brot, N. & Elkon, K. B. C-Reactive protein binds to apoptotic cells, protects the cells from assembly of the terminal complement components, and sustains an antiinflammatory innate immune response: implications for systemic autoimmunity. J. Exp. Med. 192, 1353–1364 (2000).
Casiano, C. A. & Tan, E. M. Recent developments in the understanding of antinuclear antibodies. Int. Arch. Allergy Immunol. 111, 308–313 (1996).
Postal, M. & Appenzeller, S. The role of tumor necrosis factor-alpha (TNF-α) in the pathogenesis of systemic lupus erythematosus. Cytokine 56, 537–543 (2011).
Palucka, A. K., Blanck, J. P., Bennett, L., Pascual, V. & Banchereau, J. Cross-regulation of TNF and IFN-alpha in autoimmune diseases. Proc. Natl Acad. Sci. USA 102, 3372–3377 (2005).
Dass, S., Vital, E. M. & Emery, P. Development of psoriasis after B cell depletion with rituximab. Arthritis Rheum. 56, 2715–2718 (2007).
Markatseli, T. E., Kaltsonoudis, E. S., Voulgari, P. V., Zioga, A. & Drosos, A. A. Induction of psoriatic skin lesions in a patient with rheumatoid arthritis treated with rituximab. Clin. Exp. Rheumatol. 27, 996–998 (2009).
Balato, A., La Bella, S., Gaudiello, F. & Balato, N. Efalizumab-induced guttate psoriasis. Successful management and re-treatment. J. Dermatolog. Treat. 19, 182–184 (2008).
Firmin, D., Roguedas, A. M., Lemasson, G., Abgrall, J. F. & Misery, L. Eczematous dermatosis and thrombocytosis induced by efalizumab: two new side effects. Dermatology 217, 203–206 (2008).
Ellinghaus, D. et al. Combined analysis of genome-wide association studies for Crohn disease and psoriasis identifies seven shared susceptibility loci. Am. J. Hum. Genet. 90, 636–647 (2012).
Kobayashi, T. et al. IL23 differentially regulates the Th1/Th17 balance in ulcerative colitis and Crohn's disease. Gut 57, 1682–1689 (2008).
Seiderer, J. et al. Role of the novel Th17 cytokine IL-17F in inflammatory bowel disease (IBD): upregulated colonic IL-17F expression in active Crohn's disease and analysis of the IL17F p.His161Arg polymorphism in IBD. Inflamm. Bowel Dis. 14, 437–445 (2008).
Leung, D. Y. Atopic dermatitis: new insights and opportunities for therapeutic intervention. J. Allergy Clin. Immunol. 105, 860–876 (2000).
Ma, H. L. et al. Tumor necrosis factor alpha blockade exacerbates murine psoriasis-like disease by enhancing Th17 function and decreasing expansion of Treg cells. Arthritis Rheum. 62, 430–440 (2010).
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Severine Vermeire is on the speakers bureau and receives grant/research support from Abbott, Centocor, MSD and UCB. Isabelle Cleynen declares no competing interests.
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Cleynen, I., Vermeire, S. Paradoxical inflammation induced by anti-TNF agents in patients with IBD. Nat Rev Gastroenterol Hepatol 9, 496–503 (2012). https://doi.org/10.1038/nrgastro.2012.125
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DOI: https://doi.org/10.1038/nrgastro.2012.125
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