Exacerbation of infliximab‐induced paradoxical psoriasis after ustekinumab therapy

Suh, Hyun Yi; Ahn, Ji Young; Park, Mi Youn; Youn, Jai Il

doi:10.1111/1346-8138.13803

Cited by 27 publications

(14 citation statements)

References 5 publications

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“…Experience on this matter is still insufficient, as we do not yet know the long‐term outcomes of this practice. Reports on new onset or exacerbation of previous psoriasiform reactions during ustekinumab therapy are already emerging in the literature …”

Section: Discussionmentioning

confidence: 99%

“…Reports on new onset or exacerbation of previous psoriasiform reactions during ustekinumab therapy are already emerging in the literature. 32,33 Vedolizumab, a gut-specific a4b7 integrin inhibitor, is approved for both CD and UC. 34 Switch to vedolizumab could theoretically be considered as another option for patients with anti-TNF-a-induced side effects.…”

Section: Ustekinumab and Other Potential New Therapiesmentioning

confidence: 99%

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Clinical management of Anti‐TNF‐alpha‐induced psoriasis or psoriasiform lesions in inflammatory bowel disease patients: a systematic review

Melo

Magina

2018

Int J Dermatology

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Tumor necrosis factor alpha inhibitors (anti-TNF-α) completely revolutionized the treatment of inflammatory bowel disease (IBD). However, anti-TNF-α-induced cutaneous side effects have been increasingly reported in the literature. Particularly, psoriasis and the recently recognized psoriasiform lesions are of particular concern, as anti-TNF-α agents are also used in the treatment of psoriasis, seemingly reflecting an immunological paradox. The clinical management of these cutaneous lesions is particularly challenging, owing to the potential need of anti-TNF-α discontinuation and scarcity of other therapeutic options. Therefore, optimization of current topical and systemic therapies and incorporation of new therapeutic agents is of great interest. Our aim is to review data in the literature regarding the clinical management of these cutaneous lesions and provide a therapeutic algorithm, supported by our experience as a tertiary referral center for IBD. Although in older reports no distinction was made, anti-TNF-α-induced psoriasiform lesions are not only more prevalent but also bear notable differences from classical psoriasis, possibly reflecting a different nosological entity. Onset of lesions has been related to periods of IBD remission, as supported by low levels of fecal calprotectin. Psoriasiform lesions can be adequately managed either by topical (glucocorticoids, calcineurin inhibitors, and antibiotics) or systemic (phototherapy, acitretin, glucocorticoids, and antibiotics) therapies and/or switch to other anti-TNF-α agents. Data referring to patients who were able to continue on the same IBD therapy ranged from 30.7 to 100%, reinforcing the importance of an adequate control of these lesions. The recently approved ustekinumab offers another step in the management of anti-TNF-α-intolerant patients.

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Section: Discussionmentioning

confidence: 99%

Section: Ustekinumab and Other Potential New Therapiesmentioning

confidence: 99%

Clinical management of Anti‐TNF‐alpha‐induced psoriasis or psoriasiform lesions in inflammatory bowel disease patients: a systematic review

Melo

Magina

2018

Int J Dermatology

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“…Tocilizumab and ustekinumab have been reported to be associated with psoriasis reactivation/flare‐ups . Surprisingly, exacerbation of infliximab‐induced paradoxical psoriasis after ustekinumab therapy also has been reported . Dai et al reported 2 patients with neuromyelitis optica who experienced disease exacerbation following rituximab infusion.…”

Section: Paradoxes Of Newly Emerging Drugs For Admentioning

confidence: 99%

“…84,85 Surprisingly, exacerbation of infliximab-induced paradoxical psoriasis after ustekinumab therapy also has been reported. 86 Dai et al 87 reported 2 patients with neuromyelitis optica who experienced disease exacerbation following rituximab infusion. Recently, exacerbation of pemphigus and pemphigoid after rituximab infusion also has attracted some attention.…”

Section: Paradoxes Of Newly Emerging Drugs For Admentioning

confidence: 99%

Pharmacogenetics: A strategy for personalized medicine for autoimmune diseases

2018

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For many years, a considerable number of patients with autoimmune diseases (ADs) have suffered from a lack of drug response and drug-related toxicity. Despite the emergence of new therapeutic options such as biological agents, patients continue to struggle with these problems. Unfortunately, new challenges, including the paradoxical effects of biological drugs, have complicated the situation. In recent decades, efforts have been made to predict drug response as well as drug-related side effects. Thanks to the many advances in genetics, evaluation of markers to predict drug response/toxicity before the initiation of treatment may be an avenue toward personalizing treatments. Implementing pharmacogenetics and pharmacogenomics in the clinic could improve clinical care; however, obstacles remain to effective personalized medicine for ADs. The present study attempted to clarify the concept of pharmacogenetics/pharmacogenomics for ADs. After an overview on the pathogenesis of the most common types of treatments, this paper focuses on pharmacogenetic studies related to the selected ADs. Bridging the gap between pharmacogenetics and personalized medicine is also discussed. Moreover, the advantages, disadvantages and recommendations related to making personalized medicine practical for ADs have been addressed.

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“…Dear Editor, Inhibitors of tumor necrosis factor-a (TNF-a) such as infliximab may paradoxically cause psoriasis and/or psoriatic eruptions. [1][2][3] Here, we present a case of infliximab-induced psoriasiform and pustular eruptions in addition to alopecia. This novel report presents and analyzes clinical and histopathological features of different cutaneous manifestations of a paradoxical reaction in one patient.…”

Section: Case Of Psoriasiform and Pustular Eruptions In Addition To Amentioning

confidence: 99%

Case of psoriasiform and pustular eruptions in addition to alopecia as a paradoxical reaction induced by infliximab

Shimokata

Namiki

Tokoro

et al. 2018

The Journal of Dermatology

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Exacerbation of infliximab‐induced paradoxical psoriasis after ustekinumab therapy

Cited by 27 publications

References 5 publications

Clinical management of Anti‐TNF‐alpha‐induced psoriasis or psoriasiform lesions in inflammatory bowel disease patients: a systematic review

Clinical management of Anti‐TNF‐alpha‐induced psoriasis or psoriasiform lesions in inflammatory bowel disease patients: a systematic review

Pharmacogenetics: A strategy for personalized medicine for autoimmune diseases

Case of psoriasiform and pustular eruptions in addition to alopecia as a paradoxical reaction induced by infliximab

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