Golimumab May Induce Exacerbation of Inflammatory Bowel Disease When It Is Used for the Treatment of Ankylosing Spondylitis

Abstract

Golimumab is a human IgG monoclonal antibody specific for human tumor necrosis factor alpha. Golimumab has been approved for use in rheumatological conditions; however, its use in inflammatory bowel disease is still being evaluated in clinical trials. We report a case of an exacerbation of ulcerative proctitis after starting on golimumab for ankylosing spondylitis.

Inflammatory Bowel Disease as a Paradoxical Reaction to Anti-TNF-α Treatment—A Review

“…Other authors described isolated cases of IBD in patients with AS treated with anti-TNF-alpha [ 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 ]. In almost all described isolated cases, the incriminating agent was ETN and the subtype of IBD was CD.…”

“…The diagnosis of IBD was established colonoscopically and on biopsy findings. In all the described cases, the evolution was favorable after stopping the treatment with the inducible agent and performing the therapeutic switch to another anti-TNF-α [ 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 ].…”

“…Regarding treatment with GOL, data in the literature did not report cases of de novo occurrence of IBD, but several cases of IBD flare were described [ 38 , 39 ]. Bawany reported the case of a 25-year-old man, known to have AS and UC, who developed UC exacerbation after 3 months of GOL use.…”

“…Bawany reported the case of a 25-year-old man, known to have AS and UC, who developed UC exacerbation after 3 months of GOL use. GOL was stopped, the Mesalamine dose was increased and treatment was switched to ADA [ 38 ]. Fiehn also describes three cases of IBD flares after 5 months (two cases) and 2 months, respectively, of GOL use.…”

Enfermedad inflamatoria intestinal como efecto paradójico del tratamiento con anti-TNF-α

“…Así, pueden emplearse en el tratamiento de la psoriasis, de la uveítis anterior, de la patología reumatológica y de la EII, o pueden producir cuadros similares a ellas 4,12 . Concretamente, en la aparición de EII como efecto paradójico, el fármaco biológico más implicado ha sido el etanercept 6,7,10 , si bien también se han descrito casos en pacientes que estaban bajo tratamiento con golimumab 17,18 , adalimumab o infliximab 10,19 , este último con una frecuencia claramente inferior.…”