BACKGROUND: Tumor necrosis factor (TNF)-α antagonists have been associated with the induction of de novo or worsening psoriasis. OBJECTIVE: We sought to retrospectively examine the clinical characteristics and outcomes of patients with psoriasis associated with anti-TNF-α therapy. METHODS: We performed a retrospective review of patients with new-onset or worsening psoriasis during TNF-α inhibitor therapy between 1998 and 2010. RESULTS: Of the 56 patients (mean age at psoriasis onset, 48.1 years), 41 (73%) were female. In all, 22 patients (39%) had Crohn's disease and 14 (25%) had rheumatoid arthritis. Thirty patients (54%) were treated with infliximab, 19 (34%) with adalimumab, and 7 (12%) with etanercept. New-onset or worsening psoriasis occurred after a mean treatment duration of 17.1 months. Plaque psoriasis (n = 27), palmoplantar pustulosis (n = 25), scalp psoriasis (n = 12), generalized pustular psoriasis (n = 7), erythrodermic psoriasis (n = 2), and inverse psoriasis (n = 2) were the cutaneous presentations. Among the 39 patients for whom full treatment response data were available, 33 (85%) had a complete or partial response; combined response rates (complete and partial) were slightly higher among those who discontinued anti-TNF-α therapy (16 of 17 patients [94%]) than among those who continued anti-TNF-α therapy (17 of 22 patients [77%]). LIMITATIONS: Retrospective nature, possible referral bias, and lack of complete follow-up for some patients are limitations. CONCLUSION: Although some patients sufficiently controlled their psoriasis while continuing anti-TNF-α therapy, those who discontinued therapy achieved higher rates of complete response. Further studies should explore the efficacy and safety of switching to an alternative anti-TNF-α agent.
BACKGROUND:Tumor necrosis factor (TNF)-α antagonists have been associated with the induction of de novo or worsening psoriasis. OBJECTIVE: We sought to retrospectively examine the clinical characteristics and outcomes of patients with psoriasis associated with anti-TNF-α therapy. METHODS: We performed a retrospective review of patients with new-onset or worsening psoriasis during TNF-α inhibitor therapy between 1998 and 2010. RESULTS: Of the 56 patients (mean age at psoriasis onset, 48.1 years), 41 (73%) were female. In all, 22 patients (39%) had Crohn's disease and 14 (25%) had rheumatoid arthritis. Thirty patients (54%) were treated with infliximab, 19 (34%) with adalimumab, and 7 (12%) with etanercept. New-onset or worsening psoriasis occurred after a mean treatment duration of 17.1 months. Plaque psoriasis (n = 27), palmoplantar pustulosis (n = 25), scalp psoriasis (n = 12), generalized pustular psoriasis (n = 7), erythrodermic psoriasis (n = 2), and inverse psoriasis (n = 2) were the cutaneous presentations. Among the 39 patients for whom full treatment response data were available, 33 (85%) had a complete or partial response; combined response rates (complete and partial) were slightly higher among those who discontinued anti-TNF-α therapy (16 of 17 patients [94%]) than among those who continued anti-TNF-α therapy (17 of 22 patients [77%]). LIMITATIONS: Retrospective nature, possible referral bias, and lack of complete follow-up for some patients are limitations. CONCLUSION: Although some patients sufficiently controlled their psoriasis while continuing anti-TNF-α therapy, those who discontinued therapy achieved higher rates of complete response. Further studies should explore the efficacy and safety of switching to an alternative anti-TNF-α agent.
Authors: Lauren Bonomo; Ellen H de Moll; Linden Li; Lauren Geller; Michael I Gordon; David Dunkin Journal: J Drugs Dermatol Date: 2020-03-01 Impact factor: 2.114
Authors: Vivian Huang; Neil Dhami; Darryl Fedorak; Connie Prosser; Carol Shalapay; Karen I Kroeker; Brendan P Halloran; Levinus A Dieleman; Richard N Fedorak Journal: Can J Gastroenterol Hepatol Date: 2015 Jan-Feb
Authors: Ugur Korkmaz; Ali Erkan Duman; Gokhan Dindar; Hasan Yilmaz; Ibrahim Hakki Dursun; Altay Celebi; Omer Senturk; Sadettin Hulagu Journal: Indian J Gastroenterol Date: 2013-03