Psoriasis, lymphoma and etanercept: is there a correlation?

Miranda, Ludmilla Queirós; Bressan, Aline Lopes; Rehfeldt, Fernanda Valente da Silva; Vasconcelos, Bárbara Nader; Gripp, Alexandre Carlos

doi:10.1590/s0365-05962012000100020

Cited by 2 publications

(2 citation statements)

References 10 publications

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“…An increase of developing all cancers has been found in patients with psoriasis treated with adalimumab and infliximab compared with the general population in a pooled analysis of 71 controlled trials (OR 3.3; CI 1.2-9.1) [209]. The association between tumorigenesis and anti-TNF therapy was also documented in multiple case reports [210][211][212]. In contrast, based on the data of two meta-analyses and one observational study, TNF inhibitors did not meet the statistical significance in increasing the risk of malignancy [213][214][215].…”

Section: Tnf-α Inhibitorsmentioning

confidence: 96%

Biologic and Small-Molecule Therapies for Moderate-to-Severe Psoriasis: Focus on Psoriasis Comorbidities

Jiang

Chen

et al. 2023

BioDrugs

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Psoriasis is a systemic immune-mediated disease associated with an increased risk of comorbidities, such as psoriatic arthritis, cardiovascular disease, metabolic syndrome, inflammatory bowel disease, psychiatric disorders, and malignancy. In recent years, with the advent of biological agents, the efficacy and safety of psoriasis treatments have dramatically improved. Presently, tumor necrosis factor-α inhibitors, interleukin-17 inhibitors, interleukin-12/23 inhibitors, and interleukin-23 inhibitors are approved to treat moderate-to-severe psoriasis. Small-molecule inhibitors, such as apremilast and deucravacitinib, are also approved for the treatment of psoriasis. Although it is still unclear, systemic agents used to treat psoriasis also have a significant impact on its comorbidities by altering the systemic inflammatory state. Data from clinical trials and studies on the safety and efficacy of biologics and small-molecule inhibitors provide important information for the personalized care and treatment for patients with psoriasis. Notably, treatment with interleukin-17 inhibitors is associated with new-onset or exacerbations of inflammatory bowel disease. In addition, great caution needs to be taken when using tumor necrosis factor-α inhibitors in patients with psoriasis with concomitant congestive heart failure, multiple sclerosis, and malignancy. Apremilast may induce weight loss as an adverse effect, presenting also with some beneficial metabolic actions. A better understanding of the characteristics of biologics and small-molecule inhibitors in the treatment of psoriasis comorbidities can provide more definitive guidance for patients with distinct comorbidities.

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Section: Tnf-α Inhibitorsmentioning

confidence: 96%

Biologic and Small-Molecule Therapies for Moderate-to-Severe Psoriasis: Focus on Psoriasis Comorbidities

Jiang

Chen

et al. 2023

BioDrugs

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“…On the one hand, these mechanisms should be connected with the inflammatory regulators, but on the other -and most probably -with the key proteins which regulate the processes ofthe programmed cell (apoptosis) and the blocking of the cell cycle (3). These are mechanisms which form the base for the development of skin and other neoplasms, described in a number of literary sources (3,7,8). It is assumed that one of the key regulators of the processes of cell cycle regulation, apoptosis and also the regulation of the human inflammasome could be the key adaptor protein ASCITMS I (3 ,5).…”

mentioning

confidence: 99%

Carcinoma Cuniculatum in Course of Etanercept: Blocking Autoimmunity but Propagation of Carcinogenesis?

Tchernev

Guarneri

Bevelacqua

et al. 2014

Int J Immunopathol Pharmacol

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Carcinoma cuniculatum (CC) or verrucous squamous cell carcinoma is a rare variant of squamous cell carcinoma with low incidence of metastasis. It mainly affects men during the fifth-sixth decade of life, arising mostly on the weight-bearing surface of the foot, but it can also be found in other body areas. The favorable effects on the psoriatic, rheumatoid, juvenile polyarthritis as well as the ankylosing spondylitis after the application of Tumour Necrosis Factor (TNF)-alpha inhibitors, like etanercept, presume the availability of similarity between the etiopathogenetic mechanisms which are responsible for the generation of the inflammatory cascade. According to the latest studies, the sensitivity of the patients to TNF-alpha inhibitors could be genetically determined and may also be due to certain genetic polymorphisms of the NLP3 and CARD8 zones of the inflammasome. The blocking of the inflammatory reaction within the borderlines of the psoriatic arthritis could also be accepted as something of a “double edged sword”. There is a growing volume of literary data which informs us of the clinical manifestation, not only of skin, but also of other types of tumors after the application of TNF-alpha inhibitors. This inevitably generates the hypothesis that within a certain group of patients the TNF-alpha inhibitors have some additional, and currently obscure, effects on presumably key regulatory proteins of the so-called extrinsic apoptotic pathway. Other proteins of the human inflammasome could be also implicated in the regulation of the programmed cell death and the carcinogenesis - there are speculations, that the adapter protein, ASC/TMS1, could be one of these. The present study describes the case of a patient who developed a rare form of skin tumor - epithelioma cuniculatum - whilst undergoing etanercept therapy for psoriatic arthritis. Under discussion are the possible critical connections in the complex regulatory “networks” of the inflammatory processes, the programmed cell death (apoptosis) and the carcinogenesis which, in the near or distant future, could become the objects of a targeted therapy.

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Psoriasis, lymphoma and etanercept: is there a correlation?

Cited by 2 publications

References 10 publications

Biologic and Small-Molecule Therapies for Moderate-to-Severe Psoriasis: Focus on Psoriasis Comorbidities

Biologic and Small-Molecule Therapies for Moderate-to-Severe Psoriasis: Focus on Psoriasis Comorbidities

Carcinoma Cuniculatum in Course of Etanercept: Blocking Autoimmunity but Propagation of Carcinogenesis?

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