Rheumatoid Arthritis That Developed in a Patient with Ulcerative Colitis During Adalimumab Therapy: A Case Report and Literature Review

Intern Med. 2025 Nov 1;64(21):3158-3162. doi: 10.2169/internalmedicine.5393-25. Epub 2025 Apr 26.

Abstract

Patients with ulcerative colitis (UC) treated with tumor necrosis factor (TNF) inhibitors can sometimes develop articular manifestations, but rarely rheumatoid arthritis (RA). We herein report the case of a 70-year-old woman who developed seropositive RA during adalimumab therapy for UC diagnosed 11 years previously. A literature review, including 30 patients with both UC and RA, identified three patients (10%) who developed RA after their diagnosis of UC. Notably, the present study is the only case in which RA developed during TNF inhibitor therapy for UC. This result demonstrates that arthritis in patients with UC can be caused by RA despite TNF inhibitor administration.

Keywords: rheumatoid arthritis; spondyloarthritis; tumor necrosis factor inhibitors; ulcerative colitis.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adalimumab
  • Aged
  • Antibodies, Monoclonal, Humanized* / adverse effects
  • Antibodies, Monoclonal, Humanized* / therapeutic use
  • Antirheumatic Agents* / adverse effects
  • Antirheumatic Agents* / therapeutic use
  • Arthritis, Rheumatoid* / chemically induced
  • Arthritis, Rheumatoid* / diagnosis
  • Arthritis, Rheumatoid* / etiology
  • Colitis, Ulcerative* / complications
  • Colitis, Ulcerative* / diagnosis
  • Colitis, Ulcerative* / drug therapy
  • Female
  • Humans
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors

Substances

  • Adalimumab
  • Antibodies, Monoclonal, Humanized
  • Antirheumatic Agents
  • Tumor Necrosis Factor-alpha