{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T11:00:11Z","timestamp":1792839611681,"version":"4.5.0"},"reference-count":37,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2017,11,21]],"date-time":"2017-11-21T00:00:00Z","timestamp":1511222400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2017,12]]},"abstract":"<jats:p>Primary sclerosing cholangitis (<jats:styled-content style=\"fixed-case\">PSC<\/jats:styled-content>) frequently progresses to end\u2010stage liver disease and cirrhosis, requiring liver transplantation. Approximately 70% of patients with <jats:styled-content style=\"fixed-case\">PSC<\/jats:styled-content> have concomitant inflammatory bowel disease (<jats:styled-content style=\"fixed-case\">IBD<\/jats:styled-content>) during their clinical course. After liver transplantation for <jats:styled-content style=\"fixed-case\">PSC<\/jats:styled-content>, corticosteroids and other high\u2010intensity immunosuppressants are initiated to keep <jats:styled-content style=\"fixed-case\">IBD<\/jats:styled-content> in remission. Patients with <jats:styled-content style=\"fixed-case\">IBD<\/jats:styled-content> that is refractory to these agents may need to be managed with biologic therapies. Biologic agents, however, may further increase the risks for malignancy and infection due to their immunosuppressive effects. Thus, to gain a better understanding of the risks and benefits of these agents in this high\u2010risk patient population, we performed a literature search of the PubMed database (2002\u20132017) to identify studies assessing the efficacy and safety of various biologic agents for the management of <jats:styled-content style=\"fixed-case\">IBD<\/jats:styled-content> in liver transplant recipients. No randomized controlled studies or retrospective comparative studies were identified; however, 15 case reports and case series were identified that met our inclusion criteria. From these case reports, we identified 67 patients who developed de novo or recurrent <jats:styled-content style=\"fixed-case\">IBD<\/jats:styled-content> after liver transplantation and received anti\u2013tumor necrosis factor\u2010\u03b1 or anti\u2010integrin therapy. Of the 13 published cases reporting clinical response or remission of <jats:styled-content style=\"fixed-case\">IBD<\/jats:styled-content> activity in liver transplant recipients (59 patients), clinical response or remission of <jats:styled-content style=\"fixed-case\">IBD<\/jats:styled-content> was reported in 38 (64.4%) of those patients. Adverse complications reported included cholangitis, oral candidiasis, <jats:italic>Clostridium difficile<\/jats:italic> colitis, bacterial pneumonia, cryptosporidiosis, Epstein\u2013Barr virus\u2013positive posttransplantation lymphoproliferative disease, and hepatotoxicity. Given the limited literature (case reports and case series) highlighted in this review, biologic agents such as tumor necrosis factor\u2010\u03b1 inhibitors and integrin inhibitors commonly used for moderate to severe <jats:styled-content style=\"fixed-case\">IBD<\/jats:styled-content> may be appropriate after liver transplantation; however, consideration of risk versus benefit should always occur in a patient\u2010specific manner.<\/jats:p>","DOI":"10.1002\/phar.2036","type":"journal-article","created":{"date-parts":[[2017,9,27]],"date-time":"2017-09-27T04:54:09Z","timestamp":1506488049000},"page":"1578-1585","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Safety and Efficacy of Biologic Agents for the Management of Inflammatory Bowel Disease After Liver Transplantation"],"prefix":"10.1002","volume":"37","author":[{"given":"Suhail A.","family":"Shaikh","sequence":"first","affiliation":[{"name":"Department of Pharmacy Services and Clinical Sciences University of Michigan Health System Ann Arbor Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Fitzgerald","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Services and Clinical Sciences University of Michigan Health System Ann Arbor Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Tischer","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Services and Clinical Sciences University of Michigan Health System Ann Arbor Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,11,21]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.24247"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2011.10.025"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-143-12-200512200-00007"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2006.01333.x"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2016.09.002"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.14.331"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.23678"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/MEG.0000000000000532"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/MIB.0000000000000830"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1042\/CS20110184"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v20.i13.3525"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(02)08512-4"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2005.11.030"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa067594"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2013.06.010"},{"key":"e_1_2_5_17_1","first-page":"173","article-title":"Integrin\u2010based therapeutics: biological basis, clinical use and new drugs","volume":"15","author":"Ley K","year":"2016","journal-title":"Nat Rev"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/1756283X10373176"},{"key":"e_1_2_5_19_1","unstructured":"Takeda Pharmaceuticals America Inc.Entyvio [package insert].Deerfield IL;2014."},{"key":"e_1_2_5_20_1","doi-asserted-by":"publisher","DOI":"10.2217\/imt.12.85"},{"key":"e_1_2_5_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/MEG.0b013e3280116ccc"},{"key":"e_1_2_5_22_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2010.33"},{"key":"e_1_2_5_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2012.05217.x"},{"key":"e_1_2_5_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2012.05141.x"},{"key":"e_1_2_5_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/1751-2980.12052"},{"key":"e_1_2_5_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.12256"},{"key":"e_1_2_5_27_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0135807"},{"key":"e_1_2_5_28_1","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.54.3156"},{"key":"e_1_2_5_29_1","doi-asserted-by":"publisher","DOI":"10.1093\/ecco-jcc\/jjv182"},{"key":"e_1_2_5_30_1","doi-asserted-by":"crossref","unstructured":"KarolinaS ChetanM.A unique case of biologic therapy for IBD post liver transplant. 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