Psoriasis as an adverse reaction to biologic agents beyond anti-TNF-α therapy

Karamanakos, Anastasios; Vergou, Theognosia; Panopoulos, Stylianos; Tektonidou, Maria G; Stratigos, Alexander J.; Sfikakis, Petros P.

doi:10.1684/ejd.2021.4056

Cited by 18 publications

(11 citation statements)

References 82 publications

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“…There have been few case reports of psoriasiform eruptions associated with ustekinumab. Even though this biologic has been in use for a long time, only about 10 cases of psoriasiform eruptions have been reported [ 1 , 74 ]. This may have been due to the fact that the blockade of both Th17 (IL-23) and Th1 (IL-12) responses is implicated in psoriasis caused by ustekinumab.…”

Section: Paradoxical Reactions Caused By Each Type Of Biologic Agentmentioning

confidence: 99%

“…Psoriasiform eruptions have also been reported to be associated with IL-17 inhibitors, particularly secukinumab. A systematic review of clinical reports of new-onset or flare-ups of pre-existing psoriasis induced by biologics revealed 9 cases of paradoxical psoriasis induced by secukinumab [ 74 ]. It is hypothesized that the blockade of IL-17A by secukinumab may likewise cause compensatory overproduction of the cytokines produced earlier in this pathway (IL-23 and IL-17F) or of cytokines belonging to the other arm of immunity (IL-12 and TNF-α) [ 74 ].…”

Section: Paradoxical Reactions Caused By Each Type Of Biologic Agentmentioning

confidence: 99%

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Pathogenesis of Paradoxical Reactions Associated with Targeted Biologic Agents for Inflammatory Skin Diseases

Miyagawa

2022

Biomedicines

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Targeted biologic agents have dramatically changed the therapeutic landscape for immune-mediated inflammatory diseases, particularly in rheumatology and dermatology. Their introduction has resulted in a paradigm shift, i.e., they produce significant clinical improvements in most patients with such diseases. Nevertheless, a variety of adverse reactions associated with these agents have been observed, including so-called paradoxical reactions (PRs), which are a new class of adverse events. PRs involve the de novo development or worsening of immune-mediated inflammatory disease during treatment with a targeted biologic agent that is commonly used to treat the idiopathic counterpart of the drug-induced reaction. In addition, the efficacy of biologic agents targeting individual cytokines and the existence of PRs to them have provided proof that cytokines are key drivers of various immune-mediated inflammatory diseases and helped researchers elucidate the molecular pathways underlying the pathophysiology of these diseases. Here, a comprehensive review of the targeted biologic agents used to treat immune-mediated inflammatory diseases, particularly psoriasis and atopic dermatitis, is provided, with a specific focus on biologic agents that inhibit cytokine signaling involving tumor necrosis factor-α, interleukin (IL)-12/23 (p40), IL-17A (and the IL-17 receptor [R]), IL-23 (p19), and the IL-4Rα, and their associated PRs. The characteristic clinical manifestations and potential immunological mechanisms of the PRs induced by these biologic agents are also reviewed.

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Section: Paradoxical Reactions Caused By Each Type Of Biologic Agentmentioning

confidence: 99%

Section: Paradoxical Reactions Caused By Each Type Of Biologic Agentmentioning

confidence: 99%

Pathogenesis of Paradoxical Reactions Associated with Targeted Biologic Agents for Inflammatory Skin Diseases

Miyagawa

2022

Biomedicines

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“…Il commence à y avoir de nouveaux cas décrits avec d’autres biologiques qui n’ont pas du tout le même mode d’action. Ces auteurs grecs proposent une revue de la littérature sur les psoriasis paradoxaux induits par d’autres biothérapies à l’exclusion des anti-TNF [9] . De nouveaux cas ont été décrits notamment avec le rituximab (anti-lymphocyte B), l’abatacept (anti-lymphocyte T), l’anakinra (anti-IL1), le tocilizumab (anti-IL6), l’ustékinumab (anti-IL12/23) et le sécukinumab (anti-IL17).…”

Section: Psoriasis Paradoxal : Pas Seulement Les Anti-tnfunclassified

Analyses bibliographiques d’EM-dermatologie d’octobre 2021

Kluger

Cribier

2021

Annales de Dermatologie et de Vénéréologie - FMC

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“…Regarding other chronic infections, anti-TNF-α use is not related with an increased exacerbation rate of human immunodeficiency virus (HIV) infection [ 80 , 81 ], while chronic hepatitis B and C reactivation rates remain low during anti-TNF-α treatment [ 82 , 83 ]. In addition, skin psoriasis, an anti-TNF-α-related paradoxical adverse reaction [ 84 ], was proven to be induced also by other biologic agents used in IMIDs [ 85 ]. Moreover, although elevation of serum uric acid levels after 3 months of anti-TNF-α therapy have been observed, its clinical significance remains to be elucidated [ 86 ].…”

Section: Introductionmentioning

confidence: 99%

The second decade of anti-TNF-a therapy in clinical practice: new lessons and future directions in the COVID-19 era

et al. 2022

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Since the late 1990s, tumor necrosis factor alpha (TNF-α) inhibitors (anti-TNFs) have revolutionized the therapy of immune-mediated inflammatory diseases (IMIDs) affecting the gut, joints, skin and eyes. Although the therapeutic armamentarium in IMIDs is being constantly expanded, anti-TNFs remain the cornerstone of their treatment. During the second decade of their application in clinical practice, a large body of additional knowledge has accumulated regarding various aspects of anti-TNF-α therapy, whereas new indications have been added. Recent experimental studies have shown that anti-TNFs exert their beneficial effects not only by restoring aberrant TNF-mediated immune mechanisms, but also by de-activating pathogenic fibroblast-like mesenchymal cells. Real-world data on millions of patients further confirmed the remarkable efficacy of anti-TNFs. It is now clear that anti-TNFs alter the physical course of inflammatory arthritis and inflammatory bowel disease, leading to inhibition of local and systemic bone loss and to a decline in the number of surgeries for disease-related complications, while anti-TNFs improve morbidity and mortality, acting beneficially also on cardiovascular comorbidities. On the other hand, no new safety signals emerged, whereas anti-TNF-α safety in pregnancy and amid the COVID-19 pandemic was confirmed. The use of biosimilars was associated with cost reductions making anti-TNFs more widely available. Moreover, the current implementation of the “treat-to-target” approach and treatment de-escalation strategies of IMIDs were based on anti-TNFs. An intensive search to discover biomarkers to optimize response to anti-TNF-α treatment is currently ongoing. Finally, selective targeting of TNF-α receptors, new forms of anti-TNFs and combinations with other agents, are being tested in clinical trials and will probably expand the spectrum of TNF-α inhibition as a therapeutic strategy for IMIDs.

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Psoriasis as an adverse reaction to biologic agents beyond anti-TNF-α therapy

Cited by 18 publications

References 82 publications

Pathogenesis of Paradoxical Reactions Associated with Targeted Biologic Agents for Inflammatory Skin Diseases

Pathogenesis of Paradoxical Reactions Associated with Targeted Biologic Agents for Inflammatory Skin Diseases

Analyses bibliographiques d’EM-dermatologie d’octobre 2021

The second decade of anti-TNF-a therapy in clinical practice: new lessons and future directions in the COVID-19 era

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