Etanercept/infliximab

Abstract

S Etanercept/infliximab Clear cell renal carcinoma and papillary renal carcinoma: 2 case reportsA 41-year-old man developed clear cell renal carcinoma during treatment with infliximab and a 66-year-old man developed papillary renal carcinoma during treatment with etanercept.The 41-year-old man, with a 11 year history of severe psoriasis and psoriatic arthritis, received methotrexate; however, his Psoriasis Area and Severity Index (PASI) remained at 28.9. Thus, infliximab 4 mg/kg [route not stated] was added to the treatment. At 108 weeks of infliximab, due to the development of jaundice and elevated transaminase levels he was diagnosed with hepatitis. An abdominal ultrasound revealed a mass in the right kidney and he underwent a total nephrectomy with a diagnosis of clear cell renal carcinoma by histopathological analysis. The surgery was curative and administration of leflunomide stabilized his joint symptoms and partially controlled the cutaneous lesions.The 66-year-old man with a 40 year history of psoriasis received methotrexate and was undergoing psoralen with UVA light therapy and taking acitretin; however, developed new cutaneous lesions and joint symptoms. Thus, leading to the initiation of etanercept 50 mg/week [route not stated]. After 218 weeks of etanercept, he underwent abdominal ultrasonography due to prostatic symptoms, which revealed a renal mass. He underwent a total nephrectomy with a diagnosis of papillary renal carcinoma by histopathological examination. Surgery was curative, and the administration of acitretin kept the disease under control.Author comment: "However, there is a growing concern about the safety profile, mainly due to the possible association of these drugs with an increased incidence of neoplasia. This article documents two cases of renal cell cancer during treatment with biologic therapy, reviewing the literature so far."Zarur FP, et al. Two cases of renal cell cancer during immunobiologic therapy for psoriasis. Anais Brasileiros de