Asthma Development Under Adalimumab Therapy: A Clinical Case Analysis

Abstract

Adalimumab is a human monoclonal antibody against TNFa, frequently used in chronic inflammatory diseases such as inflammatory bowel disease. Anti-TNFa drugs are generally well tolerated, but in recent years their use has revealed significant adverse effects, in particular tuberculosis. Pulmonary involvement in these contexts is sometimes encountered, in association with an extra-intestinal manifestation of the disease, or secondary to therapeutics usedq such as anti TNFa. A 46-year-old female patient with cortico-dependent ulcerative colitis presented with progressive dyspnea and cough after initiation of Adalimumab therapy. Chest imaging was consistent with interstitial pathology, and functional analysis led to a diagnosis of asthma secondary to Humira. Symptoms improved a few months after discontinuation of anti-TNFa, and functional abnormalities subsequently disappeared almost completely after corticosteroid therapy. To our knowledge, this is the third clinical case of proven asthma secondary to anti-TNF therapy, with regression of symptoms on discontinuation of treatment, and after use of corticosteroid therapy. Clinicians using this treatment should be aware of this possible complication.