Is low‐dose tumor necrosis factor inhibitor effective and safe in patients with ankylosing spondylitis flare‐up after renal transplantation? A case report and literature review

Rheumatic diseases, the immunosuppressant drugs used after solid organ transplantation to prevent graft rejection, and the biologics used for controlling rheumatic disease, especially tumor necrosis factor inhibitors (TNFi)—all of these could increase the risk of malignancy. The roles of biologics for disease control in rheumatic disease patients after kidney transplantation (KT) are not well established because only a few cases are reported, and the possibility of increasing infection and malignancy rates. Here, we present the first case of ankylosing spondylitis (AS) successfully treated with low‐dose TNFi for disease activity flare‐up 5 months after KT and review the literature to see whether the use of biologics, especially TNFi, in AS patients with disease activity flare‐ups after receiving KT is effective and safe.