Title:A Rare Case of Drug-induced Erectile Dysfunction with Adalimumab and
Certolizumab Solved after Switch to Ustekinumab in a Crohn's Disease
Patient
Volume: 18
Issue: 3
Author(s): Samuel Hidalgo-Rios*, Marta Alonso-Moreno, Jaime Torelló Iserte and Jose Manuel Herrera-Justiniano
Affiliation:
- Department of Clinical Pharmacology, University Hospital Virgen del Rocio, Av Manuel Siurot, Sevilla S/n 41013,
Spain
Keywords:
Crohn disease, sexual dysfunction, drug-related side effects, certolizumab, adalimumab, naranjo score.
Abstract:
Background: Crohn Disease (CD) is an intestinal inflammatory condition characterized
by a complex pathogenesis, with elevated levels of inflammatory cytokines. Adalimumab and certolizumab
are two biologic drugs inhibiting TNF-α.
Objective: We report the first case of a probable relationship, according to Naranjo causality assessment
score, between two consecutive treatments with TNF-α inhibitors and induced erectile
dysfunction (ED), that disappeared after switching to another biologic drug (ustekinumab).
Case Presentation: This case report describes a possible and important association of two TNF-α
inhibitors (certolizumab and adalimumab) and ED in a male patient with CD, with resolution after
switching to Ustekinumab (anti-interleukin 12 and 23 biologic drug). A 65 years old man experienced
erectile dysfunction during treatment with an anti-TNF. The adverse effect disappeared after
discontinuation of the drug. All necessary urologic exams were carried out. Adalimumab was replaced
by certolizumab and sexual disfunction symptoms appeared again, improving typically at
the end of treatment periods and getting worse with each new dose.
Results: Switching to ustekinumab lead to a resolution of the erectile dysfunction.
Conclusion: We describe for the first time a sexual dysfunction possibly due to two similar anti
TNF drugs and its resolution after the switch to another similar but different drug, highlighting the
potential difference between biologic drugs.
