Psoriasiform exfoliative erythroderma induced by golimumab

Tumor necrosis factor a (TNF-α)-targeted therapies have expanded the therapeutic options for patients with inflammatory bowel disease (IBD), rheumatoid arthritis (RA), psoriasis, and psoriatic arthritis (PsA) and have significantly improved patients' quality of life. Paradoxically, anti-TNF-α agents may induce psoriatic eruptions or worsen preexisting psoriatic skin disease. Currently, there is no standard approach for the management of TNF inhibitor-induced psoriasis. Here, we conduct a literature review on TNF inhibitor-induced psoriasis and introduce a novel treatment algorithm for maintaining otherwise effective anti-TNF therapy versus switching to a different class as appropriate in the management of patients with IBD, RA, psoriasis, or PsA.

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“…9 Of note, treatment with certolizumab pegol and golimumab has also been associated with anti-TNF-induced psoriasis in RA. 19,20…”

Section: Tumor Necrosis Factor Inhibitor-induced Psoriasis In Inflammmentioning

confidence: 99%

TNF Inhibitor-Induced Psoriasis: Proposed Algorithm for Treatment and Management

Pérez-Chada

Merola

2018

Journal of Psoriasis and Psoriatic Arthritis

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“…Two of the 17 patients in the GLM group developed psoriasis. Several studies have reported psoriasis caused by GLM, and care physicians should be aware of this adverse effect [ 31 32 ].…”

Section: Discussionmentioning

confidence: 99%

Long-Term Efficacy and Safety of Golimumab for Ulcerative Colitis in a Pediatric Inflammatory Bowel Disease Center in Japan

Tokita

Shimizu

Takeuchi

et al. 2022

Pediatr Gastroenterol Hepatol Nutr

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Purpose Golimumab (GLM) is an anti-tumor necrosis factor (TNF)-α antibody preparation known to be less immunogenic than infliximab (IFX) or adalimumab. Few reports on GLM in pediatric patients with ulcerative colitis (UC) are available. This study aimed to review the long-term durability and safety of GLM in a pediatric center. Methods The medical records of 17 pediatric patients (eight boys and nine girls) who received GLM at the National Center for Child Health and Development were retrospectively reviewed. Results The median age at GLM initiation was 13.9 (interquartile range 12.0–16.3) years. Fourteen patients had pancolitis, and 11 had severe disease (pediatric ulcerative colitis activity index ≥65). Ten patients were biologic-naïve, and 50% achieved corticosteroid-free remission at week 54. Two patients discontinued prior anti-TNF-α agents because of adverse events during remission. Both showed responses to GLM without unfavorable events through week 54. However, the efficacy of GLM in patients who showed primary nonresponse or loss of response to IFX was limited. Four of the five patients showed non-response at week 54. Patients with severe disease had significantly lower corticosteroid-free remission rate at week 54 than those without severe disease. No severe adverse events were observed during the study period. Conclusion GLM appears to be safe and useful for pediatric patients with UC. Patients with mild to moderate disease who responded to but had some adverse events with prior biologics may be good candidates for GLM. Its safety and low immunogenicity profile serve as favorable options for selected children with UC.

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“…13 Golimumab has also been implicated as a cause of PP in case reports of patients with rheumatoid arthritis but has not been linked to TNF antagonist-associated PP in IBD. 19 Furthermore, IBD patients were more likely to develop PP during TNF antagonist maintenance therapy. 15 Freling et al reported that 88.1% (52/59) patients were in clinical remission for their IBD when they developed psoriatic lesions.…”

Section: Ris K Fac Tor Smentioning

confidence: 99%

“…Conversely, Afzali and colleagues have suggested that patients who received adalimumab are more at risk of developing PP 13 . Golimumab has also been implicated as a cause of PP in case reports of patients with rheumatoid arthritis but has not been linked to TNF antagonist‐associated PP in IBD 19 …”

Section: Risk Factorsmentioning

confidence: 99%

Review article: paradoxical psoriasis as a consequence of tumour necrosis factor antagonists in patients with inflammatory bowel disease

Townsend

Lovegrove

Khanna

et al. 2022

Aliment Pharmacol Ther

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Summary Background Tumour necrosis factor (TNF) antagonists are an efficacious therapy used in the management of several immune‐mediated inflammatory diseases, including inflammatory bowel disease (IBD) and psoriasis. However, since being prescribed more widely, reports of new‐onset psoriatic lesions have began to emerge in the literature and are known as paradoxical psoriasis. Aim To review the evidence available in both the dermatology and gastroenterology literature pertaining to the entity known as paradoxical psoriasis as it relates to IBD and to create a comprehensive guide to assist clinicians who treat this challenging patient population. Methods A literature search was conducted in PubMed to identify manuscripts that presented, discussed or summarised data pertaining to paradoxical psoriasis presenting in individuals with IBD. Results Paradoxical psoriasis is now thought to be a contradictory effect of TNF antagonist therapy leading to psoriatic lesions often within the first year of treatment. The underlying pathogenesis, although not completely understood, is likely related to an imbalance of inflammatory cytokines. The histological appearance, while similar to classical psoriasis, does have unique features. The clinical presentation can vary among patients but often presents during maintenance therapy for inflammatory bowel disease. Treatment options should be determined based upon the severity of the skin lesion, activity of the underlying inflammatory bowel disease and the patient’s unique clinical history. Conclusions The approach to paradoxical psoriasis in IBD should be discussed with a multidisciplinary team to optimise and preserve intestinal disease remission and to ensure the resolution of debilitating skin lesions.

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Psoriasiform exfoliative erythroderma induced by golimumab

Cited by 8 publications

References 7 publications

TNF Inhibitor-Induced Psoriasis: Proposed Algorithm for Treatment and Management

TNF Inhibitor-Induced Psoriasis: Proposed Algorithm for Treatment and Management

Long-Term Efficacy and Safety of Golimumab for Ulcerative Colitis in a Pediatric Inflammatory Bowel Disease Center in Japan

Review article: paradoxical psoriasis as a consequence of tumour necrosis factor antagonists in patients with inflammatory bowel disease

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