Infliximab-Associated Chronic Inflammatory Central Nervous System Disease and Peroneal Nerve Injury in a Psoriatic Patient Refractory to Treatment: Case Report with 10-Year Follow-Up

Signore, Sandra C.; Brauns, Birka; Schütze, Gunther; Dohm, Christoph P.; Bähr, Mathias; Mößner, Rotraut; Kermer, Pawel

doi:10.1159/000485499

Cited by 6 publications

(4 citation statements)

References 13 publications

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“…There were fourteen cases of worsening neurological disease despite cessation of anti-TNF therapy and several reports of new, clinically silent lesions detected on follow-up imaging. 202,[205][206][207][208][209][210][211][212][213][214][215][216] A case-control study in rheumatoid arthritis using a Canadian administrative claims and electronic medical records database showed a trend towards an increased rate of demyelination in 891 patients with no risk factors (for demyelination) with the authors suggesting that TNF antagonist therapy may increase risk of truly incident demyelinating events by ~30%, although failed to meet statistical significance (adjusted rate ratio 1.31 [95% CI 0.68-2.50]). 217 To date, trial and pharmacovigilance registry data have not shown any increased risk although this may relate to a low overall incidence, as well as exclusion of people at particular risk.…”

Section: Expert Consensusmentioning

confidence: 99%

“…Of 84 cases of central demyelination reported in patients with psoriasis, the majority occurred within the first year of therapy; 33% (25/76) achieved complete recovery after cessation of anti‐TNF +/− adjunctive therapy, 72% (55/76) did not achieve complete clinical recovery after cessation of TNF antagonist therapy. There were fourteen cases of worsening neurological disease despite cessation of anti‐TNF therapy and several reports of new, clinically silent lesions detected on follow‐up imaging 202,205–216 …”

Section: Guidance For Specific Clinical and Comorbid Situationsmentioning

confidence: 99%

See 1 more Smart Citation

EuroGuiDerm Guideline on the systemic treatment of Psoriasis vulgaris – Part 2: specific clinical and comorbid situations

Nast

Smith

Spuls

et al. 2021

Acad Dermatol Venereol

110

141

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This evidence‐ and consensus‐based guideline on the treatment of psoriasis vulgaris was developed following the EuroGuiDerm Guideline and Consensus Statement Development Manual. The second part of the guideline provides guidance for specific clinical and comorbid situations such as treating psoriasis vulgaris patient with concomitant psoriatic arthritis, concomitant inflammatory bowel disease, a history of malignancies or a history of depression or suicidal ideation. It further holds recommendations for concomitant diabetes, viral hepatitis, disease affecting the heart or the kidneys as well as concomitant neurological disease. Advice on how to screen for tuberculosis and recommendations on how to manage patients with a positive tuberculosis test result are given. It further covers treatment for pregnant women or patients with a wish for a child in the near future. Information on vaccination, immunogenicity and systemic treatment during the COVID‐19 pandemic is also provided.

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Section: Expert Consensusmentioning

confidence: 99%

Section: Guidance For Specific Clinical and Comorbid Situationsmentioning

confidence: 99%

EuroGuiDerm Guideline on the systemic treatment of Psoriasis vulgaris – Part 2: specific clinical and comorbid situations

Nast

Smith

Spuls

et al. 2021

Acad Dermatol Venereol

110

141

View full text Add to dashboard Cite

show abstract

“…Other serious side effects include an increased risk of lymphoma, reactivation of TB, and an increased risk of fungal infections [82]. Infliximab may also contribute to the exacerbation of demyelinating diseases and is not preferred in patients with multiple sclerosis [112,113]. Please see full prescribing information for complete list.…”

Section: Infliximabmentioning

confidence: 99%

Biological Therapies that Target Inflammatory Cytokines to Treat Uveitis

Reddy¹,

Muhammad²,

Lee³

2019

Advances in the Diagnosis and Management of Uveitis

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Uveitis is a leading cause of blindness that presents a considerable challenge given that our understanding of the mechanisms of disease is still evolving. Both innate and adaptive immunity play a role in disease and mediators of these responses can serve as therapeutic targets. TNF-α and IL-1β inflammatory cytokines are central mediators of immunity and are involved in the dysregulated inflammatory response during uveitis. Because toxicity limits the use of steroids and other steroid-sparing agents, biologics that target a specific cell type or pathway are being explored for the treatment of autoimmune uveitis. This chapter begins with a broad overview of the aberrant immune response resulting in uveitis, and highlights key mediators such as TNF-α, IL-1β, IL-6, and IL-17 and their potential use as therapeutic targets. Most biological agents discussed in this review have not been FDAapproved for uveitis. However, favorable outcomes in early trials and FDA approval of these drugs for the treatment of other autoimmune diseases associated with uveitis support the potential for these biological agents in the management of uveitis. This review aims to provide an updated report on the efficacy of biologics that target TNF-α, IL-1β, IL-6, and IL-17 for the treatment of autoimmune uveitis.

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Section: Infliximabmentioning

confidence: 99%

Advances in the Diagnosis and Management of Uveitis

Rodríguez-García¹,

Foster²

2019

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Vogt-Koyanagi-Harada (VKH) disease is an autoimmune disorder characterized by bilateral intraocular inflammation, exudative retinal detachments, and extraocular manifestations in the auditory, integumentary, and central nervous systems (CNS). This condition is driven by T-cell-mediated autoimmunity directed against melanocytes present in the uveal tissue, in a specific genetic context. The diagnosis is based on clinical presentation, accounting with a set of standardized diagnostic criteria. Studies have reported that patients who have a significant delay in the diagnosis and/or clinical signs of the chronic stage of the disorder have a poorer prognosis and thus special efforts have to be performed in order to have an early diagnosis, together with an appropriate treatment. In that sense, the development of tools that allow us to detect this disease and its degree of severity is extremely important. In this line, novel candidate biomarkers-such as quantification of mRNA levels of NOD and glucocorticoid receptor-have been recently reported, and they represent significant advances that can help the clinician to improve patient categorization and outcomes.

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Infliximab-Associated Chronic Inflammatory Central Nervous System Disease and Peroneal Nerve Injury in a Psoriatic Patient Refractory to Treatment: Case Report with 10-Year Follow-Up

Cited by 6 publications

References 13 publications

EuroGuiDerm Guideline on the systemic treatment of Psoriasis vulgaris – Part 2: specific clinical and comorbid situations

EuroGuiDerm Guideline on the systemic treatment of Psoriasis vulgaris – Part 2: specific clinical and comorbid situations

Biological Therapies that Target Inflammatory Cytokines to Treat Uveitis

Advances in the Diagnosis and Management of Uveitis

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