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

被引：64

作者：

Guerra, Ivan ^{[1
]}

Perez-Jeldres, Tamara ^{[2
,3
]}

Iborra, Marisa ^{[3
,4
]}

Algaba, Alicia ^{[1
]}

Monfort, David ^{[5
]}

Calvet, Xavier ^{[3
,6
]}

Chaparro, Maria ^{[3
,7
]}

Manosa, Miriam ^{[3
,8
]}

Hinojosa, Esther ^{[9
]}

Minguez, Miguel ^{[10
]}

Ortiz de Zarate, Jone ^{[11
]}

Marquez, Lucia ^{[12
]}

Prieto, Vanessa ^{[13
]}

Garcia-Sanchez, Valle ^{[14
]}

Guardiola, Jordi ^{[15
]}

Esther Rodriguez, G. ^{[16
]}

Dolores Martin-Arranz, Maria ^{[17
]}

Garcia-Tercero, Ivan ^{[18
]}

Sicilia, Beatriz ^{[19
]}

Masedo, Angeles ^{[20
]}

Lorente, Rufo ^{[21
]}

Rivero, Montserrat ^{[22
]}

Fernandez-Salazar, Luis ^{[23
]}

Gutierrez, Ana ^{[3
,24
]}

Van Domselaar, Manuel ^{[25
]}

Lopez-SanRoman, Antonio ^{[26
]}

Ber, Yolanda ^{[3
,27
]}

Garcia-Sepulcre, Marife ^{[28
]}

Ramos, Laura ^{[29
]}

Bermejo, Fernando ^{[1
]}

Gisbert, Javier P. ^{[3
,7
]}

机构：

[1] Hosp Univ Fuenlabrada, Dept Gastroenterol, Madrid 28942, Spain

[2] Hosp Clin Barcelona, Dept Gastroenterol, Barcelona, Spain

[3] Ctr Invest Biomed Red Enfermedades Hepat & Digest, Dept Gastroenterol, Pamplona, Spain

[4] Hosp Univ La Fe, Dept Gastroenterol, Valencia, Spain

[5] Consorci Sanitari Terrassa, Dept Gastroenterol, Barcelona, Spain

[6] Corp Sanitaria Parc Tauli, Dept Gastroenterol, Sabadell, Spain

[7] Hosp Univ La Princesa, Inst Invest Sanitaria Princesa IIS IP, Dept Gastroenterol, Madrid, Spain

[8] Hosp Badalona Germans Trias & Pujol, Dept Gastroenterol, Badalona, Spain

[9] Hosp Manises, Dept Gastroenterol, Valencia, Spain

[10] Univ Valencia, Hosp Clin Valencia, Dept Gastroenterol, Valencia, Spain

[11] Hosp Basurto, Dept Gastroenterol, Bilbao, Spain

[12] Hosp del Mar, Dept Gastroenterol, Barcelona, Spain

[13] Hosp Univ Salamanca, Dept Gastroenterol, Salamanca, Spain

[14] Univ Cordoba, IMIBIC, Hosp Reina Sofia, Dept Gastroenterol, Cordoba, Spain

[15] Hosp Univ Bellvitge IDIBELL, Dept Gastroenterol, Barcelona, Spain

[16] Hosp Univ Nuestra Senora Candelaria, Dept Gastroenterol, Santa Cruz De Tenerife, Spain

[17] Hosp Univ La Paz, Dept Gastroenterol, Madrid, Spain

[18] Hosp Univ Santa Lucia, Dept Gastroenterol, Cartagena, Spain

[19] Hosp Univ Burgos, Dept Gastroenterol, Burgos, Spain

[20] Hosp Univ 12 Octubre, Dept Gastroenterol, Madrid, Spain

[21] Hosp Gen Univ Ciudad Real, Dept Gastroenterol, Ciudad Real, Spain

[22] Hosp Univ Marques Valdecilla, Dept Gastroenterol, Santander, Spain

[23] Hosp Clin Univ Valladolid, Dept Gastroenterol, Valladolid, Spain

[24] Hosp Gen Univ Alicante, Dept Gastroenterol, Alicante, Spain

[25] Hosp Torrejon, Dept Gastroenterol, Madrid, Spain

[26] Hosp Ramon & Cajal, Dept Gastroenterol, E-28034 Madrid, Spain

[27] Hosp Clin Lozano Blesa, Dept Gastroenterol, Zaragoza, Spain

[28] Hosp Gen Univ Elche, Dept Gastroenterol, Alicante, Spain

[29] Hosp Univ Canarias, Dept Gastroenterol, Santa Cruz De Tenerife, Spain

来源：

INFLAMMATORY BOWEL DISEASES | 2016年 / 22卷 / 04期

关键词：

ulcerative colitis; side effects; anti-TNF; Crohn's disease; infliximab; inflammatory bowel disease; adalimumab; psoriasis; NECROSIS FACTOR THERAPY; CROHNS-DISEASE; SKIN-LESIONS; ALPHA INHIBITORS; IBD PATIENTS; AGENTS; ASSOCIATION; INDUCTION; SERIES; ONSET;

D O I：

10.1097/MIB.0000000000000757

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Background: Psoriasis induced by anti-tumor necrosis factor-alpha (TNF) therapy has been described as a paradoxical side effect. Aim: To determine the incidence, clinical characteristics, and management of psoriasis induced by anti-TNF therapy in a large nationwide cohort of inflammatory bowel disease patients. Methods: Patients with inflammatory bowel disease were identified from the Spanish prospectively maintained Estudio Nacional en Enfermedad Inflamatoria Intestinal sobre Determinantes geneticos y Ambientales registry of Grupo Espanol de Trabajo en Enfermedad de Croh y Colitis Ulcerosa. Patients who developed psoriasis by anti-TNF drugs were the cases, whereas patients treated with anti-TNFs without psoriasis were controls. Cox regression analysis was performed to identify predictive factors. Results: Anti-TNF-induced psoriasis was reported in 125 of 7415 patients treated with anti-TNFs (1.7%; 95% CI, 1.4-2). The incidence rate of psoriasis is 0.5% (95% CI, 0.4-0.6) per patient-year. In the multivariate analysis, the female sex (HR 1.9; 95% CI, 1.3-2.9) and being a smoker/former smoker (HR 2.1; 95% CI, 1.4-3.3) were associated with an increased risk of psoriasis. The age at start of anti-TNF therapy, type of inflammatory bowel disease, Montreal Classification, and first anti-TNF drug used were not associated with the risk of psoriasis. Topical steroids were the most frequent treatment (70%), achieving clinical response in 78% of patients. Patients switching to another anti-TNF agent resulted in 60% presenting recurrence of psoriasis. In 45 patients (37%), the anti-TNF therapy had to be definitely withdrawn. Conclusions: The incidence rate of psoriasis induced by anti-TNF therapy is higher in women and in smokers/former smokers. In most patients, skin lesions were controlled with topical steroids. More than half of patients switching to another anti-TNF agent had recurrence of psoriasis. In most patients, the anti-TNF therapy could be maintained.

引用

页码：894 / 901

页数：8

共 31 条

[1] The association of psoriasiform rash with anti-tumor necrosis factor (anti-TNF) therapy in inflammatory bowel disease: A single academic center case series [J].

Afzali, Anita ;

Wheat, Chelle L. ;

Hu, Jie Kate ;

Olerud, John E. ;

Lee, Scott D. .

JOURNAL OF CROHNS & COLITIS, 2014, 8 (06) :480-488

[2] Sex differences and genomics in autoimmune diseases [J].

Amur, Shashi ;

Parekh, Ameeta ;

Mummaneni, Padmaja .

JOURNAL OF AUTOIMMUNITY, 2012, 38 (2-3) :J254-J265

[3] Psoriasis and smoking: a systematic review and meta-analysis [J].

Armstrong, A. W. ;

Harskamp, C. T. ;

Dhillon, J. S. ;

Armstrong, E. J. .

BRITISH JOURNAL OF DERMATOLOGY, 2014, 170 (02) :304-314

[4] Methotrexate for psoriasiform lesions associated with anti-tumour necrosis factor therapy in inflammatory bowel disease [J].

Buisson, A. ;

Cuny, J. -F. ;

Barbaud, A. ;

Schmutz, J. -L. ;

Bigard, M. -A. ;

Gueant, J. -L. ;

Peyrin-Biroulet, L. .

ALIMENTARY PHARMACOLOGY & THERAPEUTICS, 2012, 35 (10) :1175-1180

[5] A large-scale genetic association study confirms IL12B and leads to the identification of IL23R as psoriasis-risk genes [J].

Cargill, Michele ;

Schrodi, Steven J. ;

Chang, Monica ;

Garcia, Veronica E. ;

Brandon, Rhonda ;

Callis, Kristina P. ;

Matsunami, Nori ;

Ardlie, Kristin G. ;

Civello, Daniel ;

Catanese, Joseph J. ;

Leong, Diane U. ;

Panko, Jackie M. ;

McAllister, Linda B. ;

Hansen, Christopher B. ;

Papenfuss, Jason ;

Prescott, Stephen M. ;

White, Thomas J. ;

Leppert, Mark F. ;

Krueger, Gerald G. ;

Begovich, Ann B. .

AMERICAN JOURNAL OF HUMAN GENETICS, 2007, 80 (02) :273-290

[6] Paradoxical inflammation induced by anti-TNF agents in patients with IBD [J].

Cleynen, Isabelle ;

Vermeire, Severine .

NATURE REVIEWS GASTROENTEROLOGY & HEPATOLOGY, 2012, 9 (09) :496-503

[7] Psoriasis associated with anti-tumour necrosis factor therapy in inflammatory bowel disease: a new series and a review of 120 cases from the literature [J].

Cullen, G. ;

Kroshinsky, D. ;

Cheifetz, A. S. ;

Korzenik, J. R. .

ALIMENTARY PHARMACOLOGY & THERAPEUTICS, 2011, 34 (11-12) :1318-1327

[8] Psoriasis and pustular dermatitis triggered by TNF-α inhibitors in patients with rheumatologic conditions [J].

de Gannes, Gillian C. ;

Ghoreishi, Mchran ;

Pope, Janet ;

Russell, Anthony ;

Bell, David ;

Adams, Stewart ;

Shojania, Kamran ;

Martinka, Magdalena ;

Dutz, Jan P. .

ARCHIVES OF DERMATOLOGY, 2007, 143 (02) :223-231

[9] Induction or exacerbation of psoriatic lesions during anti-TNF-α therapy for inflammatory bowel disease: A systematic literature review based on 222 cases [J].

Denadai, Rafael ;

Teixeira, Fabio Vieira ;

Steinwurz, Flavio ;

Romiti, Ricardo ;

Saad-Hossne, Rogerio .

JOURNAL OF CROHNS & COLITIS, 2013, 7 (07) :517-524

[10]

Denadai Rafael, 2012, Arq. Gastroenterol., V49, P172, DOI 10.1590/S0004-28032012000200014

← 1 2 3 4 →