Role of Anti-TNFα in IBD


TNF inhibitors are drugs that help stop inflammation. They're used to treat diseases like rheumatoid arthritis (RA), juvenile arthritis, psoriatic arthritis, plaque psoriasis, ankylosing spondylitis, ulcerative colitis (UC), and Crohn's disease. They're also called TNF blockers, biologic therapies, or anti-TNF drugs.

In, inflammatory Bowel Disease (IBD), the pro-inflammatory cytokine TNFα plays a pivotal pathogenetic role, and the use of anti TNFα biologic agents is an effective therapeutical option in such patients. Despite the overall good safety profile, these drugs may produce unfavourable adverse events in particular, since TNFα in HBV patients may suppress viral replication, and then its inactivation might theoretically lead to viral reactivation and/or enhanced viral replication, with potential worsening of liver disease.

The effects of anti-TNFα on liver function in cirrhosis are largely unknown. Anti-TNFα drugs have been reported to cause acute drug induced liver injury or fulminant hepatitis per se, as described in a few cases. The mechanism by which the anti-TNFα can produce such severe side effects is unknown, but dose dependent toxicity is unlikely, since the injury can occur even after the first administration.

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Jessica Watson
Managing Editor
Clinical Gastroenterology Journal