Marijana Protic1, Alain Schoepfer2, Nikhil Yawalkar3, Stephan Vavricka4, Frank Seibold5. 1. a Department of Gastroenterology , University Hospital Zvezdara , Belgrade , Serbia. 2. b Division of Gastroenterology and Hepatology , Center Hospitalier Universitaire Vaudois , Lausanne , Switzerland. 3. c Department of Dermatology , University Hospital Bern , Bern , Switzerland. 4. d Department of Gastroenterology and Hepatology , Stadtspital Triemli , Zürich , Switzerland. 5. e Division of Gastroenterology and Hepatology , University Hospital Fribourg , Fribourg , Switzerland.
Abstract
BACKGROUND: The cause of anti-TNF-induced psoriasis is still unknown. OBJECTIVE: We aimed to evaluate if the appearance of psoriasis under anti-TNF therapy is associated with anti-TNF antibody levels and TNF-antagonist trough levels. METHODS: In this case-control study we identified 23 patients (21 with Crohn's disease [CD], two with ulcerative colitis [UC]) who developed psoriasis under infliximab (IFX, n = 20), adalimumab (ADA, n = 2), and certolizumab pegol (CZP, n= 1) and compared them regarding the anti-TNF-antagonist antibody levels with 85 IBD patients (72 with CD, 13 with UC) on anti-TNF therapy without psoriasis. RESULTS: Median disease duration was not different between the two groups (7 years in the group with psoriasis under TNF-antagonists vs. 10 years in the control group, p = 0.072). No patient from the psoriasis group had antibodies against TNF-antagonists compared to 10.6% in the control group (p = 0.103). No difference was found in IFX trough levels in the group of patients with psoriasis compared to the control group (2.6 μg/mL [IQR 0.9-5.5] vs. 3.4 μg/mL [IQR 1.4-8.1], p = 0.573). TNF-antagonist therapy could be continued in 91.3% of patients with TNF-antagonist related psoriasis and most patients responded to topical therapies. CONCLUSION: Anti-TNF-induced psoriasis seems to be independent of anti-TNF antibodies and trough levels. Interruption of Anti-TNF therapy is rarely necessary.
BACKGROUND: The cause of anti-TNF-induced psoriasis is still unknown. OBJECTIVE: We aimed to evaluate if the appearance of psoriasis under anti-TNF therapy is associated with anti-TNF antibody levels and TNF-antagonist trough levels. METHODS: In this case-control study we identified 23 patients (21 with Crohn's disease [CD], two with ulcerative colitis [UC]) who developed psoriasis under infliximab (IFX, n = 20), adalimumab (ADA, n = 2), and certolizumab pegol (CZP, n= 1) and compared them regarding the anti-TNF-antagonist antibody levels with 85 IBDpatients (72 with CD, 13 with UC) on anti-TNF therapy without psoriasis. RESULTS: Median disease duration was not different between the two groups (7 years in the group with psoriasis under TNF-antagonists vs. 10 years in the control group, p = 0.072). No patient from the psoriasis group had antibodies against TNF-antagonists compared to 10.6% in the control group (p = 0.103). No difference was found in IFX trough levels in the group of patients with psoriasis compared to the control group (2.6 μg/mL [IQR 0.9-5.5] vs. 3.4 μg/mL [IQR 1.4-8.1], p = 0.573). TNF-antagonist therapy could be continued in 91.3% of patients with TNF-antagonist related psoriasis and most patients responded to topical therapies. CONCLUSION: Anti-TNF-induced psoriasis seems to be independent of anti-TNF antibodies and trough levels. Interruption of Anti-TNF therapy is rarely necessary.
Authors: Adam V Weizman; Robyn Sharma; N M Afzal; Wei Xu; Scott Walsh; Joanne M Stempak; Geoffrey C Nguyen; Ken Croitoru; A Hillary Steinhart; Mark S Silverberg Journal: Dig Dis Sci Date: 2018-05-08 Impact factor: 3.199
Authors: Lisa H Buckley; Rui Xiao; Marissa J Perman; Andrew B Grossman; Pamela F Weiss Journal: Arthritis Care Res (Hoboken) Date: 2021-01-03 Impact factor: 4.794