Dermatomyositis in Patients with Rheumatoid Arthritis During Adalimumab Therapy

Nagashima, Takao; Minota, Seiji

doi:10.3899/jrheum.100947

Cited by 12 publications

(5 citation statements)

References 10 publications

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“…In this study, a neutrophilic infiltrate was observed in three specimens belonging to one patient. Review of clinical data revealed that this patient had DM triggered by adalimumab which was administered for rheumatoid arthritis, a clinical setting previously reported 16,17 . A diagnosis of rheumatoid neutrophilic dermatitis was excluded based on the absence of annular lesions and leukocytoclasia on biopsy 18 .…”

Section: Discussionmentioning

confidence: 84%

“…Review of clinical data revealed that this patient had DM triggered by adalimumab which was administered for rheumatoid arthritis, a clinical setting previously reported. 16,17 A diagnosis of rheumatoid neutrophilic dermatitis was excluded based on the absence of annular lesions and leukocytoclasia on biopsy. 18 While the presence of neutrophils is not classically described in DM, further studies are required to determine whether a neutrophilic infiltrate correlates with drug-induced DM.…”

Section: Discussionmentioning

confidence: 99%

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Do histopathological features correlate with systemic manifestations in dermatomyositis? Analysis of 42 skin biopsy specimens from 22 patients

et al. 2022

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Background Understanding whether specific histopathologic features on skin biopsy are predictive of systemic associations in dermatomyositis (DM) would be useful to guide clinical screening. Methods Through retrospective medical record search, clinical and laboratory findings of patients with DM were documented. Existing skin biopsy slides were re‐reviewed blindly. Results Of all biopsy specimens (n = 42), the most frequent histopathological finding was vacuolar interface dermatitis (95%). Other features included perivascular lymphocytic infiltrate (71%), increased dermal mucin (40%), vessel wall thickening (12%), follicular plugging (9.5%), and dermal sclerosis (7%). Neutrophilic infiltrate was observed in three biopsies from a patient with adalimumab‐associated DM. Vasculitis was not observed. There was no statistically significant difference in the presence of any histopathological feature and that of various systemic manifestations (i.e., myopathy, interstitial lung disease [ILD] and malignancy). However, we observed that dense lichenoid infiltrate rather than pauci‐inflammatory changes correlated with severe itching (p < 0.001). Patients with MDA‐5 antibodies were significantly more likely to have vasculopathy than those without (p = 0.029*). Conclusions No dermatopathologic feature was reliably predictive of myopathy, ILD, or malignancy. This finding implies that, regardless of histopathologic findings, patients should be screened for associated conditions as clinically indicated.

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Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Do histopathological features correlate with systemic manifestations in dermatomyositis? Analysis of 42 skin biopsy specimens from 22 patients

et al. 2022

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“…13 In a recent retrospective review, among 75 patients with PM or DM, 5 (6.7%) developed PM or DM from 0.25 to 23 years after a diagnosis of rheumatoid arthritis. 14 The causality of the cutaneous features of DM from anti-TNF therapy is clear in the case presented herein, given the long-standing history of arthritis from childhood, the recurrence of symptoms after rechallenge with a second anti-TNF agent, and improvement after discontinuation of anti-TNF therapy. In addition, only 1 other case in the literature has reported recurrence of anti-TNF-induced DM symptoms after rechallenge with a second anti-TNF agent, in that case with adalimumab followed by infliximab.…”

Section: Discussionmentioning

confidence: 79%

Dermatomyositis Induced by Anti–Tumor Necrosis Factor in a Patient With Juvenile Idiopathic Arthritis

et al. 2013

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“…Despite that a recent RCT showed efficacy of infliximab (IFX) in some patients [ 110 •], the majority of clinical data was discouraging [ 111 , 112 ]. Moreover, some authors reported that anti-TNF alpha therapy may induce myositis in patients with rheumatoid arthritis, psoriatic arthritis, and psoriasis [ 113 , 114 ]. In summary, TNF blockers are generally not recommended in adult patients with IIM and they should be used only when other therapies are ineffective.…”

Section: Treatmentmentioning

confidence: 99%

Current Treatment for Myositis

Barsotti

Lundberg

2018

Curr Treat Options in Rheum

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Purpose of reviewThe purpose of this review was to give an update on treatment modalities for patients with idiopathic inflammatory myopathies, or shortly myositis, excluding the subgroup inclusion body myositis, based on a literature survey on therapies used in myositis. Few controlled trials have been performed in patients with myositis; therefore, we also included a summary of open-label trials, case series, and case reports.Recent findingsGlucocorticoid (GC) in high doses is still the first-line treatment of patients with myositis. There is a general recommendation to combine GCs with another immunosuppressive agent in the early phase of disease to better control disease activity and possibly to reduce the risk for GC-related side effects. Furthermore, combining pharmacological treatment with individualized and supervised exercise can be recommended based on evidence. There is some evidence for the effect of rituximab in patients with certain myositis-specific autoantibodies, whereas other biologic agents are currently being tested in clinical trials.SummaryImmunosuppressive treatment in combination with exercise is recommended for patients with myositis to reduce disease activity and improve muscle performance. Subgrouping of patients into clinical and serological subtypes may be a way to identify biomarkers for response to specific immunosuppressive and biological agents and should be considered in future trials.

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Dermatomyositis in Patients with Rheumatoid Arthritis During Adalimumab Therapy

Cited by 12 publications

References 10 publications

Do histopathological features correlate with systemic manifestations in dermatomyositis? Analysis of 42 skin biopsy specimens from 22 patients

Do histopathological features correlate with systemic manifestations in dermatomyositis? Analysis of 42 skin biopsy specimens from 22 patients

Dermatomyositis Induced by Anti–Tumor Necrosis Factor in a Patient With Juvenile Idiopathic Arthritis

Current Treatment for Myositis

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