Incidence, Clinical Characteristics, and Management of Psoriasis Induced by Anti-TNF Therapy in Patients with Inflammatory Bowel Disease

Guerra, Iván; Pérez-Jeldres, Tamara; Iborra, Marisa; Algaba, Alicia; Monfort, David; Calvet, Xavier; Chaparro, María; Mañosa, Míriam; Hinojosa, Esther; Mínguez, Miguel; Zárate, Jone Ortiz de; Márquez, Lucía; Prieto, Vanessa; García–Sánchez, Valle; Guardiola, Jordi; Rodríguez, G E; Martín-Arranz, María Dolores; García-Tercero, Iván; Sicilia, Beatriz; Masedo, Ángeles; Lorente, Rufo; Rivero, Montserrat; Fernández-Salazar, Luis; Gutiérrez, Ana; Domselaar, Manuel Van; López-Sanromán, Antonio; Ber, Yolanda; García-Sepulcre, M F; Ramos, Laura; Bermejo, Fernando

doi:10.1097/mib.0000000000000757

Cited by 77 publications

(108 citation statements)

References 23 publications

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“…It is also appropriate to mention here that psoriasis, systemic lupus erythematosus, and sarcoidosis are viewed as anti-TNFα-induced morbidities or paradoxical phenomena 7,14,17. Further, most cases of psoriasis in IBD patients under anti-TNF therapy are considered paradoxical reactions for the fact that anti-TNF biologics have shown efficacy in non-IBD patients with psoriasis 8.…”

Section: Discussionmentioning

confidence: 99%

“…Currently, anti-TNFα biologics, including infliximab and adalimumab, are widely used to treat inflammatory bowel diseases (IBDs), which include Crohn’s disease (CD), and paradoxical events like psoriasis are not uncommon observations during anti-TNF therapy 5–7. The paradox is that anti-TNF biologics have shown efficacy in patients with psoriasis 8.…”

Section: Introductionmentioning

confidence: 99%

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Paradoxical SAPHO syndrome observed during anti-TNF-α therapy for Crohn's disease

Amano¹,

Matsuda²,

Shibata³

et al. 2017

BTT

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Currently, anti-TNFα antibodies are used to treat Crohn’s disease. We report on a 45-year-old Japanese female with Crohn’s disease developing SAPHO (synovitis, acne, pustulosis, hyperostosis, and osteitis) syndrome following exposure to the anti-TNFα antibody adalimumab. Initially, adalimumab induced remission, but the patient showed SAPHO syndrome 11 weeks following the start of adalimumab therapy for the first time. Cutaneous and articular involvement were exacerbating the condition, so adalimumab was discontinued and the patient was put on low-dose methotrexate to control her symptoms. To our knowledge, this is the first report of SAPHO syndrome occurring during anti-TNF therapy, which is thought to be a paradoxical response to adalimumab.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Paradoxical SAPHO syndrome observed during anti-TNF-α therapy for Crohn's disease

Amano¹,

Matsuda²,

Shibata³

et al. 2017

BTT

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“…These include patients with psoriasis and Crohn’s disease as well as those who develop TNF-antagonist-induced psoriasis 73. Paradoxical psoriasis induced by TNF antagonists has been described to involve 1.7%–10% of described cohorts, and identified risk factors include cigarette smoking status, female sex, and younger age of initiation of TNF antagonist in certain cohorts 73–75. In a cohort of 434 IBD patients, 21 of whom developed psoriasis, all nine patients with Crohn’s disease and severe psoriasiform lesions and/or TNF-antagonist-induced alopecia were successfully treated with ustekinumab.…”

Section: Potential Place In Therapymentioning

confidence: 99%

Ustekinumab in treatment of Crohn’s disease: design, development, and potential place in therapy

Deepak¹,

Loftus²

2016

DDDT

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Crohn’s disease is characterized by a dysregulation of both innate and adaptive immunity responses. Interleukin-12/23 (IL-12/23) pathway has been found to be a major driver of inflammation in adaptive immune responses. Ustekinumab is a fully human immunoglobulin G1 kappa monoclonal antibody that blocks the p40 subunit of IL-12 and IL-23 and prevents their interaction with their cell surface receptor and further cytokine activation. It is currently approved in the management of plaque psoriasis and psoriatic arthritis. Very promising data have emerged through phase II and phase III trials (UNITI-1, UNITI-2, and IM-UNITI) for both induction and maintenance of clinical response and remission in moderate-to-severe Crohn’s disease, resulting in approval by the Food and Drug Administration for this condition. This article reviews the immunology of the IL-12/23 pathway, available data regarding the initial designing of ustekinumab, drug development through clinical trials including pharmacokinetics, efficacy, and safety, and its potential place in the treatment of Crohn’s disease.

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“…180 A recent multicenter study of 7415 patients in Spain, treated for IBD with anti-TNF drugs, noted an incidence of psoriasis of 0.5% per patient year. 181 A substantial proportion (40%) of patients were transferred to another anti-TNF agent without recurrence, but most (60%) experienced the same reaction. Fortunately, standard treatments for psoriasis, usually topical steroids, controlled the disease and allowed continuation of anti-TNF therapy in most cases.…”

Section: Skin Lesionsmentioning

confidence: 99%

Update on anti-tumor necrosis factor agents and other new drugs for inflammatory bowel disease

Cohen

Sachar

2017

BMJ

115

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The treatment of inflammatory bowel disease (IBD)-ulcerative colitis (UC) and Crohn's disease (CD)-has evolved beyond surgery with the introduction of biologic agents, primarily antibodies against mediators of inflammation and cell attraction. Anti-tumor necrosis factor (TNF) agents have been the first line treatment for moderate to severe ulcerative colitis and Crohn's disease for more than 15 years. During that time much has been learnt about how best to use these agents. This review will assess the evidence on how to optimize the use of anti-TNF agents; when and how to start treatment; how to monitor treatment and when to de-escalate it; and the potential adverse effects of these drugs. New and emerging treatments such as anti-attractants, anti-interleukins, and Janus kinase (JAK) inhibitors will also be discussed.

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Incidence, Clinical Characteristics, and Management of Psoriasis Induced by Anti-TNF Therapy in Patients with Inflammatory Bowel Disease

Cited by 77 publications

References 23 publications

Paradoxical SAPHO syndrome observed during anti-TNF-α therapy for Crohn's disease

Paradoxical SAPHO syndrome observed during anti-TNF-α therapy for Crohn's disease

Ustekinumab in treatment of Crohn’s disease: design, development, and potential place in therapy

Update on anti-tumor necrosis factor agents and other new drugs for inflammatory bowel disease

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Incidence, Clinical Characteristics, and Management of Psoriasis Induced by Anti-TNF Therapy in Patients with Inflammatory Bowel Disease

Cited by 77 publications

References 23 publications

Paradoxical SAPHO syndrome observed during anti-TNF-&alpha; therapy for Crohn&#39;s disease

Paradoxical SAPHO syndrome observed during anti-TNF-&alpha; therapy for Crohn&#39;s disease

Ustekinumab in treatment of Crohn&rsquo;s disease: design, development, and potential place in therapy

Update on anti-tumor necrosis factor agents and other new drugs for inflammatory bowel disease

Contact Info

Product

Resources

About

Paradoxical SAPHO syndrome observed during anti-TNF-α therapy for Crohn's disease

Paradoxical SAPHO syndrome observed during anti-TNF-α therapy for Crohn's disease

Ustekinumab in treatment of Crohn’s disease: design, development, and potential place in therapy