Development of Crohn's disease in a patient with multiple sclerosis treated with Copaxone

Background: Copaxone (glatiramer acetate) is a synthetic copolymer mimicking a portion of myelin basic protein, one of several putative autoantigens in multiple sclerosis (MS). Copaxone suppresses the production of tumor necrosis factor (TNF)-alpha, a key mediator of inflammation in MS as well as in other pathologies, such as colitis of interstitial bowel disease (IBD). Copaxone is a drug approved for the treatment of MS, and one that is very well tolerated with a high safety profile and relatively few side effects. Crohn's disease has not been associated with its administration. Methods: We describe a patient with MS in remission who had not exhibited any signs of IBD in the past. She had been on Copaxone 20 mg/day treatment for 2 years when she first exhibited gastrointestinal symptoms. Results: Our patient developed Crohn's disease while on Copaxone treatment as a consequence of long-term immunosuppression. Conclusions: Clinicians should be aware that Crohn's disease is a potential novel adverse drug effect of Copaxone. Copyright (C) 2008 S. Karger AG, Basel.