Tumor necrosis factor-α inhibitor-induced psoriasis: Systematic review of clinical features, histopathological findings, and management experience

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• 作者：Gabrielle Brown ; MD ; MS^a ; Eva Wang ; MD^a ; Argentina Leon ; MD^a ; Monica Huynh ; DO^a ; Mackenzie Wehner ; MD^a ; Rebecca Matro ; MD^b ; Eleni Linos ; MD ; PhD^a ; Wilson Liao ; MD^a ; Anna Haemel ; MD^a ; ^{Anna.Haemel@ucsf.edu}
• 关键词：adalimumab ; adverse event ; certolizumab ; etanercept ; golimumab ; infliximab ; medication side effect ; psoriasis ; tumor necrosis factor-α-induced psoriasis ; tumor necrosis factor-α inhibitor
• 刊名：Journal of the American Academy of Dermatology
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：76
• 期：2
• 页码：334-341
• 全文大小：350 K
• 卷排序：76

文摘

Tumor necrosis factor-α (TNF-α) inhibitors have been reported to induce new-onset psoriasis.ObjectiveTo better define the demographic, clinical features, and treatment approach of TNF-α inhibitor-induced psoriasis.MethodsSystematic review of published cases of TNF-α inhibitor-induced psoriasis.ResultsWe identified 88 articles with 216 cases of new-onset TNF-α inhibitor-induced psoriasis. The mean age at psoriasis onset was 38.5 years. The most common underlying diseases were Crohn disease (40.7%) and rheumatoid arthritis (37.0%). Patients underwent TNF-α therapy for an average of 14.0 months before psoriasis onset with 69.9% of patients experiencing onset within the first year. The majority of patients received skin-directed therapy, though patients who discontinued TNF therapy had the greatest resolution of symptoms (47.7%) compared with those who switched to a different TNF agent (36.7%) or continued therapy (32.9%).LimitationsRetrospective review that relies on case reports and series.ConclusionWhile TNF-α inhibitor cessation may result in resolution of induced psoriasis, lesions may persist. Decisions regarding treatment should be weighed against the treatability of TNF-α inhibitor-induced psoriasis, the severity of the background rheumatologic or gastrointestinal disease, and possible loss of efficacy with cessation followed by retreatment. Skin-directed therapy is a reasonable initial strategy except in severe cases.