Tumor necrosis factor-? inhibitor-induced psoriasis: Systematic review of clinical features, histopathological findings, and management experience - 18/04/17
Abstract |
Background |
Tumor necrosis factor-α (TNF-α) inhibitors have been reported to induce new-onset psoriasis.
Objective |
To better define the demographic, clinical features, and treatment approach of TNF-α inhibitor-induced psoriasis.
Methods |
Systematic review of published cases of TNF-α inhibitor-induced psoriasis.
Results |
We identified 88 articles with 216 cases of new-onset TNF-α inhibitor-induced psoriasis. The mean age at psoriasis onset was 38.5 years. The most common underlying diseases were Crohn disease (40.7%) and rheumatoid arthritis (37.0%). Patients underwent TNF-α therapy for an average of 14.0 months before psoriasis onset with 69.9% of patients experiencing onset within the first year. The majority of patients received skin-directed therapy, though patients who discontinued TNF therapy had the greatest resolution of symptoms (47.7%) compared with those who switched to a different TNF agent (36.7%) or continued therapy (32.9%).
Limitations |
Retrospective review that relies on case reports and series.
Conclusion |
While TNF-α inhibitor cessation may result in resolution of induced psoriasis, lesions may persist. Decisions regarding treatment should be weighed against the treatability of TNF-α inhibitor-induced psoriasis, the severity of the background rheumatologic or gastrointestinal disease, and possible loss of efficacy with cessation followed by retreatment. Skin-directed therapy is a reasonable initial strategy except in severe cases.
Le texte complet de cet article est disponible en PDF.Key words : adalimumab, adverse event, certolizumab, etanercept, golimumab, infliximab, medication side effect, psoriasis, tumor necrosis factor-α-induced psoriasis, tumor necrosis factor-α inhibitor
Abbreviations used : AS, AZA, CD, IFN-α, IL, IL-23R, MeSH, MTX, RA, TH, TNF-α, UC
Plan
| Drs Brown and Wang are co-first authors. |
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| Supported in part by grants from the National Institutes of Health (R01AR065174 and K08AR057763) to WL. National Clinical and Translational Science Institute (8KL2TR000143) to EL, and Dermatology Foundation Career Development Awards to EL and AH. |
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| Conflicts of interest: None declared. |
Vol 76 - N° 2
P. 334-341 - février 2017 Retour au numéro
Article précédent
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