Incidence of New-onset and Flare of Preexisting Psoriasis During Rituximab Therapy for Rheumatoid Arthritis: Data from the French AIR Registry

Abstract

Despite the small number of cases observed, leading to wide CI, the incidence rates in our study do not support a causative role of rituximab therapy in new-onset or flare of preexisting psoriasis in patients with RA.

Dr. Hardcastle, et al reply

“…This effect has not yet been observed in registry-based studies 4 , suggesting that the overall incidence is small. As the authors point out, the particularly interesting thing about this case is that the patient had previously received a number of other biologic agents, in contrast to our patient, who was biologic-naive.…”

Beyond antibodies: B cells in Hidradenitis Suppurativa: Bystanders, contributors or therapeutic targets?

“…The anti‐inflammatory mechanisms of B cells are mediated through the production of IL‐10 and IL‐35 [51,52] . This is thought to explain the paradoxical induction or exacerbation of psoriasis from B‐cell depletion therapy [52,53] . Suggestions of elevated IL‐35 are seen in both psoriasis and HS.…”

New Onset of Psoriasis in a Patient with Rheumatoid Arthritis Treated with Rituximab

“…All these data were limited, but we would remind readers that the development of psoriasis under TNF-α blockers was not observed during randomized clinical trials but with the use of these drugs in real-life practice. Thomas, et al reported 2 cases of new onset of psoriasis from the AIR registry, but these cases were not confirmed (no dermatological diagnosis for 1 case and the second was a patient-reported skin lesion) 1 . Their calculated incidence rate of new-onset psoriasis was low (0.52 to 1.04/1000 person-years) and did not argue for a causative role of RTX, a conclusion that must be tempered by the unconfirmed dermatological diagnosis.…”

“…We describe a patient with refractory RA who received 3 successive anti-TNF-α agents, abatacept, and RTX. New-onset psoriasis under RTX has been reported in a limited number of cases (n = 6), both in biologic-naive patients 3 and in patients previously treated with TNF-α-blocking agents or anakinra 1,4 . In all these cases, the patients had no personal or family history of psoriasis and they did not take a medication known to induce psoriasis.…”