Eczematous reaction to ixekizumab successfully treated with dupilumab

Napolitano, Maddalena; Gallo, Lucia; Patruno, Cataldo; Fabbrocini, Gabriella; Megna, Matteo

doi:10.1111/dth.13218

Cited by 10 publications

(7 citation statements)

References 5 publications

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“…There have been anecdotal case reports showing exacerbation of AD-like dermatitis after treatment with anti-IL17 antibody for psoriasis [57][58][59]. A 31-year-old man with severe psoriasis treated with ixekizumab presented with a one-month history of pruritic lesions [57].…”

Section: Other Biologics and Admentioning

confidence: 99%

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The Role of Th17-Related Cytokines in Atopic Dermatitis

Sugaya

2020

IJMS

150

102

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T helper-17 (Th17) cells, which mainly produce IL-17, are associated with development of various autoimmune diseases such as rheumatoid arthritis, inflammatory bowel diseases, multiple sclerosis, and psoriasis. IL-17 and related cytokines are therapeutic targets of these diseases. In atopic dermatitis (AD), Th2 cytokines such as IL-4 and IL-13 are regarded to be the main player of the disease; however, Th17 cytokines are also expressed in AD skin lesions. Expression of IL-22 rather than IL-17 is predominant in AD skin, which is contrary to cytokine expression in psoriasis skin. Relatively low IL-17 expression in AD skin can induce relatively low antimicrobial peptide expression, which may be a reason why bacterial infection is frequently seen in AD patients. Failure of clinical trials for investigating the efficacy of anti-IL-12/23 p40 in AD has suggested that IL-17 expressed in skin lesions should not be the main player but a bystander responding to barrier dysfunction.

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Section: Other Biologics and Admentioning

confidence: 99%

“…IL-17A Worsening of dermatitis [57][58][59] IL-12/23p40 No effect in clinical trial [55,56] IL-22 Effective for some patients [60,61] IL-4/13 Very effective [68]…”

Section: Clinical Response Referencesmentioning

confidence: 99%

The Role of Th17-Related Cytokines in Atopic Dermatitis

Sugaya

2020

IJMS

150

102

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“…Atopic dermatitis was previously thought to involve a mechanism of inflammatory response centered on Th2/Th22 cells, unlike psoriasis, which is characterized by Th1/Th17-type inflammatory response [ 70 ]. Subsequent studies have found that psoriasis and atopic dermatitis can be classified as two ends of the same spectrum, referred to as “psoriatic dermatitis” [ 71 ], and that the two are interchangeable, especially in patients applying biologic agents, which have been attributed to immune drift [ 72 , 73 ]. The association between cardiovascular disease and psoriasis is not only exerted through cross-cutting inflammatory responses, but additionally, comorbidities of psoriasis, such as hypertension, diabetes, obesity, and dyslipidemia, are responsible for cardiovascular disease, rendering it an interdisciplinary concern.…”

Section: Discussionmentioning

confidence: 99%

Knowledge Mapping and Research Hotspots of Comorbidities in Psoriasis: A Bibliometric Analysis from 2004 to 2022

Huang

Bai

2023

Medicina

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Background and Objectives: Psoriasis is a chronic inflammatory disease whose impact on health is not only limited to the skin, but is also associated with multiple comorbidities. Early screening for comorbidities along with appropriate treatment plans can provide a positive prognosis for patients. This study aimed to summarize the knowledge structure in the field of psoriasis comorbidities and further explore its research hotspots and trends through bibliometrics. Materials and Methods: A search was conducted in the core collection of the Web of Science for literature on comorbidities of psoriasis from 2004 to 2022. VOSviewer and CiteSpace software were used for collaborative network analysis, co-citation analysis of references, and keyword co-occurrence analysis on these publications. Results: A total of 1803 papers written by 6741 authors from 81 countries was included. The publications have shown a progressive increase since 2004. The United States and Europe were at the forefront of this field. The most prolific institution was the University of California, and the most productive author was A. Armstrong. Research has focused on “psoriatic arthritis”, “metabolic syndrome”, “cardiovascular disease”, “psychosomatic disease”, “inflammatory bowel disease”, “prevalence”, “quality of life”, and “risk factor” in the past 18 years. Keywords such as “biologics” and “systemic inflammation”, have been widely used recently, suggesting current research hotspots and trends. Conclusions: Over the past 18 years, tremendous progress has been made in research on psoriasis comorbidity. However, collaborations among countries, institutions, and investigators are inadequate, and the study of the mechanisms of interaction between psoriasis and comorbidities and management of comorbidities is insufficient. The treatment of comorbidities with biologic agents, screening of comorbidities, and multidisciplinary co-management are predicted to be the focus of future research.

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“… 1 Particularly, the so‐called paradoxical reactions to biologics are emerging. 2 In this context, eczematous eruptions (EE), which have already been observed with anti‐TNF‐α, are increasingly being reported with anti‐interleukin(IL)‐17A (ixekizumab and secukinumab) 2 , 3 , 4 ; conversely, to date no EE case linked to brodalumab (anti‐IL17 receptor) has been described.…”

Section: Figurementioning

confidence: 99%

“… 6 The immunological pathway of atopic eczema is complex and heterogeneous. 2 , 3 It is possible that interference with several members of the IL‐17 family induced an imbalance towards the Th2 arm, although this is a rare event given the important role of IL‐17 in atopic eczema. However, the pathogenesis of biologic induced EE is yet to be clarified as demonstrated by their possible occurrence also during anti‐IL‐23.…”

Section: Figurementioning

confidence: 99%

Eczematous eruption after brodalumab successfully treated with guselkumab and dupilumab

Megna

Genco

Noto

et al. 2022

Dermatologic Therapy

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Biological drugs have completely revolutionized the management of chronic inflammatory skin diseases, such as psoriasis. However, their use has also raised new possible adverse events. 1 Particularly, the socalled paradoxical reactions to biologics are emerging. 2 In this context, eczematous eruptions (EE), which have already been observed with anti-TNF-α, are increasingly being reported with anti-interleukin(IL)-17A (ixekizumab and secukinumab) 2-4 ; conversely, to date no EE case linked to brodalumab (anti-IL17 receptor) has been described.We report the first case of EE in a patient under brodalumab treatment. A 62-year-old man with a 15-year history of psoriasis presented with a diffuse pruritic rash. His medical history was negative for childhood atopic dermatitis (AD), although positive for allergic rhinitis, hypertension, latent tuberculosis infection (LTBI) and mild renal failure. He had been treated with methotrexate and apremilast with inconsistent improvements. After LTBI prophylaxis brodalumab was started with complete disease control (Psoriasis Area Severity Index decreased from 38 to 1.8 after 12 weeks). This result was maintained up to 8 months

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Eczematous reaction to ixekizumab successfully treated with dupilumab

Cited by 10 publications

References 5 publications

The Role of Th17-Related Cytokines in Atopic Dermatitis

The Role of Th17-Related Cytokines in Atopic Dermatitis

Knowledge Mapping and Research Hotspots of Comorbidities in Psoriasis: A Bibliometric Analysis from 2004 to 2022

Eczematous eruption after brodalumab successfully treated with guselkumab and dupilumab

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