Development of Crohn's disease following anti-tumour necrosis factor therapy (etanercept).
ABSTRACT Inhibition of tumour necrosis factor (TNF)-alpha is effective in the treatment of rheumatoid arthritis and other inflammatory rheumatic diseases. Anti-TNF antibodies such as infliximab, etanercept and adalimumab are commonly used. There are structural and functional differences among these agents. We describe development of Crohn's disease in a patient with ankylosing spondylitis receiving anti-TNF therapy. This case suggests that the appearance of gastrointestinal symptoms in patients on anti-TNF therapy must be evaluated to find out whether this is a new onset or an exacerbation of underlying inflammatory bowel disease.
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ABSTRACT: In the past, there has been considerable focus on a host of drugs and chemicals that may produce colonic toxicity. Now, a variety of new biological monoclonal antibody agents, usually administered by infusion, have appeared in the clinical realm over the last decade or so to treat different chronic inflammatory or malignant disorders.For some of these agents, adverse effects have been documented, including apparently new forms of immune-mediated inflammatory bowel disease. In some, only limited symptoms have been recorded, but in others, severe colitis with serious complications, such as bowel perforation has been recorded. In others, adverse effects may have a direct vascular or ischemic basis, while other intestinal effects may be related to a superimposed infection. Some new onset cases of ulcerative colitis or Crohn's disease may also be attributed to the same agents used to treat these diseases, or be responsible for disease exacerbation. Dramatic and well documented side effects have been observed with ipilimumab, a humanized monoclonal antibody developed to reduce and overcome cytotoxic T-lymphocyte antigen 4, a key negative feedback regulator of the T-cell anti-tumor response. This agent has frequently been used in the treatment of different malignancies, notably, malignant melanoma. Side effects with this agent occur in up to 40% and these are believed to be largely immune-mediated. One of these is a form of enterocolitis that may be severe, and occasionally, fatal. Other agents include rituximab (an anti-CD20 monoclonal antibody), bevacizumab (a monoclonal antibody against the vascular endothelial growth factor) and anti-tumor necrosis factor agents, including infliximab, adalimumab and etanercept.World Journal of Gastroenterology 04/2012; 18(16):1871-4. · 2.55 Impact Factor
- Journal of clinical rheumatology: practical reports on rheumatic & musculoskeletal diseases 09/2012; 18(6):325. · 1.19 Impact Factor
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ABSTRACT: The catalytic activity of a ruthenium(II)-p-cymene complex containing a partially coordinated triphosphine ligand, [RuCl(κ2-triphos)(p-cymene)]PF61, has been investigated in the hydrogenation of styrene to ethylbenzene. The influence of arene dissociation and coordination of the free phosphine donor group on the catalytic activity have been probed directly and indirectly by comparison to structural analogues. Analogues of 1 containing in a diphosphine ligand, [RuCl(κ2-dppp)(p-cymene)]PF62, or a labile arene ligand, [RuCl(κ2-triphos)(η6-PhCO2Et)]PF63, show significantly enhanced catalytic activity – demonstrating the importance of ligand coordination/dissociation dynamics in ruthenium(II)-arene compounds during catalysis. These observations are supported by thermolysis reactions of 1 in DMSO. In addition, improved syntheses of 1 and 2 are reported together with the solid-state structures of syn-1, syn-3 and [Ru(η3-C8H13)(κ3-triphos)]PF6.Journal of Organometallic Chemistry 07/2011; 696(13):2485-2490. · 2.00 Impact Factor