Disproportional increase in psoriasis reports in association with B cell depleting therapies in patients with multiple sclerosis

Porwal, Mokshal H; Patel, Dhruvkumar; Maynard, Michelle; Obeidat, Ahmed Z.

doi:10.1016/j.msard.2022.103832

Cited by 6 publications

(7 citation statements)

References 29 publications

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“…9 Finally, a recent analysis of Food and Drug Administration (FDA) data showed that psoriasis was more frequently reported in patients with MS treated with anti-CD20 therapies. 10 It is difficult to establish a causal relationship, whether this is a drug reaction, an unmasking of a previous vulnerability or secondary autoimmunity. Psoriasis characteristically presents at age 15-20 years, with a second peak in incidence between 50 and 60 years, and follows a relapsing and remitting course.…”

Section: Discussionmentioning

confidence: 99%

Psoriasiform dermatitis following ocrelizumab in relapsing-remitting multiple sclerosis: Case report and literature review

Emma,

Vesela,

Kay

et al. 2024

Mult Scler

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We present a case of a 30-year-old man with relapsing-remitting multiple sclerosis who developed psoriasiform dermatitis following his second course of ocrelizumab. This resolved with topical therapies and discontinuation of treatment. Cases of psoriasiform rashes have been increasingly reported in the use of ocrelizumab and are possibly due to B-cell (CD20) depletion and T-cell overregulation. Nevertheless, skin-related adverse reactions are not yet considered in the risk management plans of anti-CD20 treatments in multiple sclerosis.

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Section: Discussionmentioning

confidence: 99%

Psoriasiform dermatitis following ocrelizumab in relapsing-remitting multiple sclerosis: Case report and literature review

Emma,

Vesela,

Kay

et al. 2024

Mult Scler

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“…A descriptive study in the United States concluded that the proportion of PsD induced by B‐lymphocyte‐depleting drugs for the treatment of MS was disproportionately high compared to other treatments used for the disease 7 . There are few studies focusing on the role of B‐lymphocyte in psoriasis, with several hypotheses proposed.…”

Section: Discussionmentioning

confidence: 99%

“…However, it is not known whether OCR causes these effects. Finally, an increased susceptibility to infection from anti‐CD20 therapy could act as a trigger factor for psoriasis 7–9 …”

Section: Discussionmentioning

confidence: 99%

“…6 A descriptive study in the United States concluded that the proportion of PsD induced by B-lymphocyte-depleting drugs for the treatment of MS was disproportionately high compared to other treatments used for the disease. 7 There are few studies focusing on the role of B-lymphocyte in psoriasis, with several hypotheses proposed. The most widely accepted involves an immunomodulatory action of a subtype of B-lymphocytes (regulatory B-lymphocytes) on macrophages and T-lymphocytes, through the secretion of interleukin-10.…”

Section: Discussionmentioning

confidence: 99%

“…Finally, an increased susceptibility to infection from anti-CD20 therapy could act as a trigger factor for psoriasis. [7][8][9] The presented cases of anti-CD20-induced PsD highlight the importance of continuous monitoring of new treatments in terms of dermatological side effects and the induction of skin diseases, in particular psoriasis. There is also a need to inform the professional community about the possibility of psoriasis in patients with MS and the consequences of this condition.…”

Section: Discussionmentioning

confidence: 99%

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Ocrelizumab‐induced psoriasiform dermatitis: Case reports and review of the literature

Naranjo Guerrero,

González Quesada,

García Minarro

et al. 2023

JEADV Clinical Practice

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Ocrelizumab (OCR) is a humanized anti‐CD20 monoclonal antibody approved for treating multiple sclerosis. We present three patients who developed psoriasiform dermatitis (PsD) during OCR treatment and a review of the cases published to date. We hereby report the first exclusive fingernail involvement. Most of the cases had a mild skin involvement and only one case required OCR discontinuation. No association with arthritis, personal or family history of psoriasis was found. Data compiled suggests that PsD tends to appear within the first year of treatment. There are few studies focusing on B‐lymphocytes in psoriasis and several hypotheses attempt to explain their role. The most widely accepted is the depletion of regulatory B‐lymphocytes with immunomodulatory function through interleukin‐10. However, the exact mechanism by which this occurs with OCR remains unclear and the presented case of anti‐CD20‐induced PsD highlights the importance of continuous monitoring of new treatments in terms of dermatological side effects and the induction of skin diseases, in particular psoriasis. There is also a need to inform the professional community about the possibility of psoriasis in patients with multiple sclerosis and the consequences of this condition.

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The immunological understanding on germinal center B cells in psoriasis

Noor,

Nor,

Redzwan

2024

Journal Cellular Physiology

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The development of psoriasis is mainly driven by the dysregulation of T cells within the skin, marking a primary involvement of these cells in the pathogenesis. Although B cells are integral components of the immune system, their role in the initiation and progression of psoriasis is not as pivotal as that of T cells. The paradox of B cell suggests that, while it is crucial for adaptive immunity, B cells may contribute to the exacerbation of psoriasis. Numerous ideas proposed that there are potential relationships between psoriasis and B cells especially within germinal centers (GCs). Recent research projected that B cells might be triggered by autoantigens which then induced molecular mimicry to alter B cells activity within GC and generate autoantibodies and pro‐inflammatory cytokines, form ectopic GC, and dysregulate the proliferation of keratinocytes. Hence, in this review, we gathered potential evidence indicating the participation of B cells in psoriasis within the context of GC, aiming to enhance our comprehension and advance treatment strategies for psoriasis thus inviting many new researchers to investigate this issue.

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Disproportional increase in psoriasis reports in association with B cell depleting therapies in patients with multiple sclerosis

Cited by 6 publications

References 29 publications

Psoriasiform dermatitis following ocrelizumab in relapsing-remitting multiple sclerosis: Case report and literature review

Psoriasiform dermatitis following ocrelizumab in relapsing-remitting multiple sclerosis: Case report and literature review

Ocrelizumab‐induced psoriasiform dermatitis: Case reports and review of the literature

The immunological understanding on germinal center B cells in psoriasis

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