F Prignano1, L Pescitelli, F Ricceri, A Ermini, T Lotti. 1. Department of Dermatological Sciences, Florence University, Santa Maria Annunziata Hospital, Florence, Italy. francesca.prignano@unifi.it
Abstract
BACKGROUND: Monoclonal gammopathies are haematological conditions characterized by the clonal proliferation of plasma cells which produce a monoclonal immunoglobulin that accumulates in the blood. They have already been reported during treatment with a range of drugs but never before during treatment with the anti-TNF-α treatments: adalimumab, etanercept and infliximab currently used in the therapy of moderate-severe psoriasis and psoriatic arthritis. OBJECTIVE: This is a case series describing the development of MGUS in psoriatic patients treated with anti-TNF-α. METHODS: Three hundred patients receiving an anti-TNF-α treatment for chronic plaque psoriasis or psoriatic arthritis in a clinical setting in Italy, These patients were screened through serum protein electrophoresis to investigate the possible development of MGUS. RESULTS: Eight patients were found to have developed monoclonal gammopathy of undetermined significance. The median treatment duration for the eight patients was 1 year with excessive IgG present in five patients, IgM accumulation in one patient and a double monoclonal component in two patients. CONCLUSION: Our data suggest that there may be an association between anti-TNF-α therapy and development of MGUS.
BACKGROUND:Monoclonal gammopathies are haematological conditions characterized by the clonal proliferation of plasma cells which produce a monoclonal immunoglobulin that accumulates in the blood. They have already been reported during treatment with a range of drugs but never before during treatment with the anti-TNF-α treatments: adalimumab, etanercept and infliximab currently used in the therapy of moderate-severe psoriasis and psoriatic arthritis. OBJECTIVE: This is a case series describing the development of MGUS in psoriaticpatients treated with anti-TNF-α. METHODS: Three hundred patients receiving an anti-TNF-α treatment for chronic plaque psoriasis or psoriatic arthritis in a clinical setting in Italy, These patients were screened through serum protein electrophoresis to investigate the possible development of MGUS. RESULTS: Eight patients were found to have developed monoclonal gammopathy of undetermined significance. The median treatment duration for the eight patients was 1 year with excessive IgG present in five patients, IgM accumulation in one patient and a double monoclonal component in two patients. CONCLUSION: Our data suggest that there may be an association between anti-TNF-α therapy and development of MGUS.
Authors: Normann Steiner; Georg Göbel; Daniela Michaeler; Anna-Luise Platz; Wolfgang Prokop; Anna Maria Wolf; Dominik Wolf; Christina Duftner; Eberhard Gunsilius Journal: Blood Adv Date: 2021-03-23