Reacciones paradójicas de los tratamientos biológicos utilizados en psoriasis: revisión de la literatura

Munera‐Campos, Mónica; Ballescá, F.; Carrascosa, J.M.

doi:10.1016/j.ad.2018.04.003

Cited by 35 publications

(6 citation statements)

References 88 publications

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“…However, psoriasis can also be triggered by biologics [43,44], and this is recognized as paradoxical reactions. Although most of the paradoxical reactions reported have been associated with the use of tumor necrosis factor (TNF)-α inhibitors, other biologics targeting interleukin (IL)-23 and IL-17 are increasingly common [45]. Biologics targeting TNF-α, IL-23, and IL-17 block immune signaling pathways, which can lead to cytokine imbalances [45].…”

Section: Extrinsic Risk Factorsmentioning

confidence: 99%

“…Although most of the paradoxical reactions reported have been associated with the use of tumor necrosis factor (TNF)-α inhibitors, other biologics targeting interleukin (IL)-23 and IL-17 are increasingly common [45]. Biologics targeting TNF-α, IL-23, and IL-17 block immune signaling pathways, which can lead to cytokine imbalances [45]. Paradoxical reactions are thought to be due to an imbalance in cytokine production with an overproduction of IFN-α and altered lymphocyte recruitment and migration [45,46].…”

Section: Extrinsic Risk Factorsmentioning

confidence: 99%

“…Biologics targeting TNF-α, IL-23, and IL-17 block immune signaling pathways, which can lead to cytokine imbalances [45]. Paradoxical reactions are thought to be due to an imbalance in cytokine production with an overproduction of IFN-α and altered lymphocyte recruitment and migration [45,46]. Suspected drugs should be discontinued and switched to an alternative drug in patients with drug-related psoriasis.…”

Section: Extrinsic Risk Factorsmentioning

confidence: 99%

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Risk Factors for the Development of Psoriasis

Kamiya

Kishimoto

Sugai

et al. 2019

IJMS

421

306

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Psoriasis is an immune-mediated genetic skin disease. The underlying pathomechanisms involve complex interaction between the innate and adaptive immune system. T cells interact with dendritic cells, macrophages, and keratinocytes, which can be mediated by their secreted cytokines. In the past decade, biologics targeting tumor necrosis factor-α, interleukin (IL)-23, and IL-17 have been developed and approved for the treatment of psoriasis. These biologics have dramatically changed the treatment and management of psoriasis. In contrast, various triggering factors can elicit the disease in genetically predisposed individuals. Recent studies suggest that the exacerbation of psoriasis can lead to systemic inflammation and cardiovascular comorbidity. In addition, psoriasis may be associated with other auto-inflammatory and auto-immune diseases. In this review, we summarize the risk factors, which can be divided into two groups (namely, extrinsic and intrinsic risk factors), responsible for the onset and exacerbation of psoriasis in order to facilitate its prevention.

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Section: Extrinsic Risk Factorsmentioning

confidence: 99%

Section: Extrinsic Risk Factorsmentioning

confidence: 99%

Section: Extrinsic Risk Factorsmentioning

confidence: 99%

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Risk Factors for the Development of Psoriasis

Kamiya

Kishimoto

Sugai

et al. 2019

IJMS

421

306

View full text Add to dashboard Cite

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“… 11 – 13 Different theories have been proposed to explain these paradoxical reactions to biologic agents, including an imbalance in cytokine production, unopposed production of interferon alpha (IFN-α), and a shift towards a Th1 cytokine profile. 14 , 15 While the IFN-α pathway has been identified as an alternative pathway in paradoxical psoriasis reactions caused by biologic therapy, 16 the pathogenesis of IL-17 inhibitor-induced pyoderma gangrenosum is largely unknown and there are likely multiple inflammatory pathways of disease induction.…”

Section: Discussionmentioning

confidence: 99%

Pyoderma gangrenosum treated with secukinumab: A case report

McPhie

Kirchhof

2020

SAGE Open Medical Case Reports

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Pyoderma gangrenosum is a challenging disease to manage, due in part to the lack of approved treatment therapies. Recently, the emergence of biologic agents has expanded treatment options, with tumour necrosis factor alpha inhibitors being the best supported in the literature. In our report, we present a 50-year-old female with pyoderma gangrenosum who was successfully treated with the anti-interleukin-17 biologic agent, secukinumab, after failing other systemic therapies.

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“…Insufficient data are available concerning the incidence of PAEs [ 13 ]. Most paradoxical reactions have been reported to be connected with anti-TNF therapy; however, it is possible that the number of cases will increase as the number of newly introduced biological agents increases [ 14 ]. Representative examples of PAEs are palmoplantar pustular reactions, psoriasiform reactions, and hidradenitis suppurativa (HS) in patients under treatment for rheumatoid arthritis (RA) or inflammatory bowel disease (IBD) [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

New Biologics for the Treatment of Atopic Dermatitis: Analysis of Efficacy, Safety, and Paradoxical Atopic Dermatitis Acceleration

2021

BioMed Research International

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Atopic dermatitis (AD) is a chronic, inflammatory skin disease with an eczematous rash and itching. Due to undesired adverse effects of traditional systemic treatment, there is still an unmet need for safe and effective long-term therapy for refractory AD. As our understanding of the pathogenesis underlying AD grows, novel treatments targeting specific molecules have been developed. Here, we discuss the efficacy and safety profiles of these drugs in recent clinical trials. Among their adverse effects, of particular note is AD acceleration. Although there is still debate about whether certain adverse reactions can be said to be paradoxical adverse events (PAEs), a wide range of PAEs have been reported during biological treatment for chronic immune-mediated diseases. Close surveillance of novel biologics is crucial to detect new undescribed paradoxical reactions and to shed light on the convoluted pathogenesis of AD.

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Reacciones paradójicas de los tratamientos biológicos utilizados en psoriasis: revisión de la literatura

Cited by 35 publications

References 88 publications

Risk Factors for the Development of Psoriasis

Risk Factors for the Development of Psoriasis

Pyoderma gangrenosum treated with secukinumab: A case report

New Biologics for the Treatment of Atopic Dermatitis: Analysis of Efficacy, Safety, and Paradoxical Atopic Dermatitis Acceleration

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