ReviewRMD open2016
Paradoxical reactions under TNF-α blocking agents and other biological agents given for chronic immune-mediated diseases: an analytical and comprehensive overview.
Review in RMD open, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 87 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
87 citing papers in PubMed, 2 syntheses or guidelines pooled it, 195 citations in OpenAlex.
- The role of interleukin-17 inhibition in systemic lupus erythematosus-paradoxical hindrance or new therapeutic potential? Results from a systematic literature review and mendelian randomization.Frontiers in immunology · 2026Pooled it
- Paradoxical psoriasis induced by IL-17 inhibitors: a case series of patients with axial spondyloarthritis and a systematic literature review.Rheumatology international · 2024Pooled it
- Paradoxical psoriasis in axial spondyloarthritis and rheumatoid arthritis treated with b/tsDMARDs: a retrospective cohort study.Clinical rheumatology · 2026Article
- Retroperitoneal Fibrosis following Etanercept for Ankylosing Spondylitis.Mediterranean journal of rheumatology · 2026Article
- Current landscape of drug induced retinal vasculitis.Journal of ophthalmic inflammation and infection · 2026Review
- Sarcoidosis-like reaction associated with tocilizumab in a patient with giant cell arteritis: a case based review.Rheumatology international · 2026Article
- Benralizumab for anti-tumor necrosis factor-associated eosinophilic gastrointestinal disease in a child with ileal Crohn's: A case report.JPGN reports · 2026Article
- Dual-Site Inflammation During Adalimumab Therapy: Birdshot Chorioretinopathy Complicated by Paradoxical Psoriasis.Cureus · 2026Article
- Foreign body granuloma following leech therapy in hidradenitis suppurativa: A case complicated by lymphedema.Dermatology online journal · 2026Article
- [Skin reactions under therapy with biologics].Zeitschrift fur Rheumatologie · 2026Article
- Paradoxical inflammatory switches during biologic therapy: a mechanistic framework, clinical algorithm, and pediatric illustrations.Frontiers in pediatrics · 2026Article
- Recurrent acute bilateral cicatricial conjunctivitis as an adverse event of systemic adalimumab for rheumatoid arthritis.Digital journal of ophthalmology : DJO · 2026Article
- Article
- Rates of Drug-Induced Uveitis: A Review by Medication Class.Clinical ophthalmology (Auckland, N.Z.) · 2026Review
- Case Report: Anti-TNF-α therapy-associated destructive thyroiditis and unmasking of latent amyloid A amyloidosis in rheumatoid arthritis.Frontiers in immunology · 2026Article
- Drug-associated inflammatory bowel disease: a real-world pharmacovigilance study using the FAERS and JADER databases.Frontiers in immunology · 2026Article
- Transient Visual Loss due to Infliximab Administration: A New Adverse Event to Biologic Therapy in Crohn's Disease.ACG case reports journal · 2025Article
- Etanercept-induced sarcoidosis presenting with bilateral panuveitis: diagnostic value of ocular signs and therapeutic response to IL-17A inhibition-a case-based review.Clinical rheumatology · 2025Review
- Real-world treatment patterns for patients with non-infectious uveitis in Japan: a descriptive study using a large-scale claims database (J-CAT study).Journal of ophthalmic inflammation and infection · 2025Article
- Article
27 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Paradoxical adverse events (PAEs) have been reported during biological treatment for chronic immune-mediated diseases. PAEs are defined as the occurrence during biological agent therapy of a pathological condition that usually responds to this class of drug. A wide range of PAEs have been reported including dermatological, intestinal and ophthalmic conditions, mainly with antitumour necrosis factor α (TNF-α) agents. True PAEs include psoriasis, Crohn's disease and hidradenitis suppurativa. Other PAEs may be qualified as borderline and include uveitis, scleritis, sarcoidosis and other granulomatous diseases (granuloma annulare, interstitial granulomatous dermatitis), vasculitis, vitiligo and alopecia areata. Proposed hypotheses to explain these PAEs include an imbalance in cytokine production, the differential immunological properties between the monoclonal antibodies and TNF-α soluble receptor, an unopposed type I interferon production and a shift towards a Th1/Th2 profile. Data from registries suggest that the risk for paradoxical psoriasis is low and non-significant. We discuss management of these PAEs, which depends on the type and severity of the adverse events, pre-existing treated conditions and the possibility of alternative therapeutic options for the underlying disease. Paradoxical adverse events are not restricted to anti-TNF-α agents and close surveillance of new available biological drugs (anti-interleukin-17/23, anti-integrin) is warranted in order to detect the occurrence of new or as yet undescribed events.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.