Triple paradoxical reaction due to adalimumab

Mir-Bonafé, Juan Francisco; López‐Ferrer, Anna; Laíz, A.; Puig, Lluís

doi:10.1111/jdv.13732

Cited by 3 publications

(4 citation statements)

References 10 publications

(10 reference statements)

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“…After abstract/title screening of 404 studies and full-text screening of 31 studies, 23 articles met the aforementioned inclusion criteria (Figure, Table, Supplemental Table 3, http://links.lww.com/NSW/A111). 9–31 This review presents a total of 57 patients between 24 and 82 years of age (mean, 51.3 years). Of the 57 patients, 10.5% were men (n = 6/57), 82.5% were women (n = 47/57), and the sex of 7.0% of patients was not reported (n = 4/57).…”

Section: Resultsmentioning

confidence: 99%

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Onset of Pyoderma Gangrenosum in Patients on Biologic Therapies: A Systematic Review

Mufti

Maliyar

Sachdeva

et al. 2022

Adv Skin Wound Care

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OBJECTIVE:To summarize clinical outcomes of paradoxical pyoderma gangrenosum (PG) onset in patients on biologic therapy. METHODS:The authors conducted MEDLINE and EMBASE searches using PRISMA guidelines to include 57 patients (23 reports). RESULTS:Of the included patients, 71.9% (n = 41/57) noted PG onset after initiating rituximab, 21.1% (n = 12/57) noted tumor necrosis factor α (TNF-α) inhibitors, 5.3% (n = 3/57) reported interleukin 17A inhibitors, and 1.8% (n = 1/57) reported cytotoxic T-lymphocyte-associated protein 4 antibodies. The majority of patients (94.3%) discontinued biologic use. The most common medications used to resolve rituximab-associated PG were intravenous immunoglobulins, oral corticosteroids, and antibiotics, with an average resolution time of 3.3 months. Complete resolution of PG in TNF-α-associated cases occurred within an average of 2.2 months after switching to another TNF-α inhibitor (n = 1), an interleukin 12/23 inhibitor (n = 2), or treatment with systemic corticosteroids and cyclosporine (n = 3), systemic corticosteroids alone (n = 1), or cyclosporine alone (n = 1). CONCLUSIONS:Further investigations are warranted to determine whether PG onset is associated with underlying comorbidities, the use of biologic agents, or a synergistic effect. Nevertheless, PG may develop in patients on rituximab or TNF-α inhibitors, suggesting the need to monitor and treat such adverse effects.

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Section: Resultsmentioning

confidence: 99%

“…Anti-CD20 (n = 41) [9][10][11][12][13][14][15] TNF-α Inhibitor (n = 12) [16][17][18][19][20][21][22][23][24][25][26][27] IL-17A Inhibitor (n = 3) [28][29][30] CTLA-4 Antibody (n = 1) 31 Biologic name (n) Rituximab ( 41) Infliximab ( 5) Adalimumab ( 4) Certolizumab ( 1) Etanercept ( 1)…”

Section: Table Summary Of Pg Reactions During Treatment With Differen...mentioning

confidence: 99%

Onset of Pyoderma Gangrenosum in Patients on Biologic Therapies: A Systematic Review

Mufti

Maliyar

Sachdeva

et al. 2022

Adv Skin Wound Care

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“…The clinical presentation of drug-induced PG in the reported cases was variable, although in nearly half of the cases (6/13) ulcerations were present in different body areas (multifocal PG), with the lower portion of the legs as a commonly involved site (8/13). Interestingly, in some cases PG onset was accompanied by extracutaneous symptoms such as fever and anterior uveitis ( 72 ), pyogenic arthritis of the left knee ( 71 ), and bilateral sacroiliitis along with psoriasiform palmar eruption ( 69 ). A paradoxical skin reaction characterized by an overlap between pustular psoriasis and PG lesions was also reported ( 74 ).…”

Section: Anti Tnf Drug-induced Pgmentioning

confidence: 99%

“…To the best of our knowledge 13 additional cases of PG during anti TNF-α therapy have been reported in the literature (Table 2) (8,(63)(64)(65)(66)(67)(68)(69)(70)(71)(72)(73)(74)(75). All the licensed anti TNF-α agents (etanercept, adalimumab, infliximab, golimumab and certolizumab) have been reported in association to drug-induced PG; nearly half of the cases (7/13) were due to adalimumab (monoclonal antibody binding soluble and membrane bound TNF-α).…”

Section: Anti Tnf Drug-induced Pgmentioning

confidence: 99%

Pyoderma gangrenosum following anti-TNF therapy in chronic recurrent multifocal osteomyelitis: drug reaction or cutaneous manifestation of the disease? A critical review on the topic with an emblematic case report

et al. 2023

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Chronic recurrent multifocal osteomyelitis (CRMO) is a rare autoinflammatory disease, clinically characterized by chronic and recurrent episodes of osteoarticular inflammation, that generally presents in children and adolescents. From a dermatological point-of-view, CMRO can be associated with skin rashes mainly including psoriasis, palmoplantar pustulosis and acne. Pyoderma gangrenosum (PG) is a rare immune-mediated inflammatory skin disease classified within the spectrum of neutrophilic dermatoses that, in some cases, has been reported as cutaneous manifestation in CMRO patients. This paper presents a 16-year female patient diagnosed with CMRO, who presented PG lesions located on the lower leg, that arose after the administration of the tumour necrosis factor (TNF)-α inhibitor adalimumab. Cases of PG have been reported in patients being treated with certain medications, including TNF-α antagonists, leading to classified them in a setting aptly termed “drug-induced PG.” In this paper, we discuss the co-occurrence of PG and CRMO, in the light of recent evidence on the pathogenesis of both diseases and giving ample space to a literature review on drug induced PG. In our case, it is plausible that PG could be considered a cutaneous manifestation of CRMO, although the mechanisms underlying this intriguingly relationship remain to be fully unraveled.

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Adalimumab

2017

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Triple paradoxical reaction due to adalimumab

Cited by 3 publications

References 10 publications

Onset of Pyoderma Gangrenosum in Patients on Biologic Therapies: A Systematic Review

Onset of Pyoderma Gangrenosum in Patients on Biologic Therapies: A Systematic Review

Pyoderma gangrenosum following anti-TNF therapy in chronic recurrent multifocal osteomyelitis: drug reaction or cutaneous manifestation of the disease? A critical review on the topic with an emblematic case report

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