Anti-TNF agents in patients with inflammatory bowel disease and malignant melanoma-challenges in management

International Journal of Colorectal Disease
Jungmin Lee, Kofi Clarke

Abstract

The inflammatory bowel diseases (IBD) are chronic immune-mediated inflammatory diseases of the gut that occur in genetically predisposed individuals exposed to environmental triggers. Several immunosuppressive agents have been successfully used for induction and maintenance treatment in inflammatory bowel disease. These include steroids, thiopurines, methotrexate, anti-tumor necrosis factor (anti-TNF) alpha agents, anti-alpha 4 integrins, and anti-IL-12/23 agent to name a few. There are also limited data on novel approaches including thalidomide and stem cell transplant. In spite of the significant successes associated with these agents, numerous malignancies have been associated with their use. Lymphomas including hepatosplenic T cell lymphomas, non-melanoma skin cancers and, more recently, melanoma have been described, specifically with anti-TNF. We reviewed the available published literature on melanoma in IBD, melanoma associated with anti-TNF, and the data on other treatment options in patients with IBD. In addition, we also reviewed the limited data on the gut specific integrin-vedolizumab. This may provide an additional option in the management of the subset of patients with IBD and melanoma. Options for treatment of IBD...Continue Reading

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Citations

Mar 28, 2021·Joint, Bone, Spine : Revue Du Rhumatisme·Joanna KedraRaphaèle Seror
Jun 18, 2021·Journal of Gastroenterology and Hepatology·Justin LeeSwapna Gayam

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