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A.S. Cheifetz, J.D. Feuerstein (eds.), Treatment of Inflammatory
Bowel Disease with Biologics, https://doi.org/10.1007/978-3-319-60276-9_14
Chapter 14
Noninfectious and Nonmalignant
Complications of Anti-TNF Therapy
Uni Wong and Raymond K. Cross
Introduction
Biologics, namely, monoclonal antibodies including anti-TNF and anti-integrin
agents, are frequently used in the treatment of moderate to severe inflammatory
bowel disease (IBD). The noninfectious and nonmalignant complications of
biologics include infusion or injection site reactions, psoriasiform and eczema-
tous eruptions, lupus-like reaction, hepatotoxicity, demyelination, and heart
failure. In the majority of these cases, the adverse events are reversible with
discontinuation of the offending biologic or can be managed with supportive
care without discontinuation of therapy. Early recognition and management of
these complications is important to minimize suffering from adverse events, to
initiate supportive treatment, and to transition to other therapies when needed.
This chapter focuses on the clinical presentation, pathophysiology, diagnostic
evaluation, and management of the noninfectious and nonmalignant complica-
tions of biologics. The majority of our knowledge on the safety of biologics is
based on clinical studies on infliximab and adalimumab given their extended
use in the treatment of IBD.
U. Wong
Division of Gastroenterology and Hepatology, Department of Medicine, University of
Maryland Medical Center, Baltimore, MD 21201, USA
R.K. Cross (*)
University of Maryland Medical Center, 100 North Greene St, Baltimore, MD 21201, USA
e-mail: [email protected]