Use of infliximab in a patient with pyoderma gangrenosum and rheumatoid arthritis

Tada, Masahiro; Nakanishi, Takeshi; Hirata, Chika; Okano, Tadashi; Sugioka, Y.; Wakitani, Shigeyuki; Nakamura, Hiroaki; Koike, Tatsuya

doi:10.1007/s10165-010-0336-0

Cited by 7 publications

(8 citation statements)

References 28 publications

(35 reference statements)

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“…91 Infliximab has been used to treat idiopathic PG, 92 disseminated PG, 93 refractory PG in an 11-month-old child, 94 a patient with PG, acne conglobata, hidradenitis suppurativa (HS), and axial spondyloarthritis, 95 and a patient with PG and RA. 96 The use of infliximab as an adjunct to surgery also has been successful. 97 Although the application of infliximab gel was effective in one patient with ulcerative colitis, sublesional injection of infliximab weekly for 3 weeks in a different patient did not appear to be effective.…”

Section: Resultsmentioning

confidence: 99%

Off-Label uses of Biologic Agents Approved for Psoriasis and Psoriatic Arthritis for Dermatological Conditions: Part I

Elbendary

Kellen

2016

Journal of Psoriasis and Psoriatic Arthritis

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Over the past decade or so, the treatment of patients with psoriasis has been revolutionized by the development of the biological agents, monoclonal antibodies that target specific aspects of the inflammatory cascades. The biologic agents approved by the Food and Drug Administration for psoriasis and psoriatic arthritis include adalimumab, etanercept, infliximab, ustekinumab, and secukinumab. The advantages of these agents are numerous: they are dosed less frequently than previously used systemic agents, they have a more favorable safety profile, and they have incredible efficacy even in patients resistant to standard treatment. There are abundant reports of off-label uses of these drugs for other dermatological conditions and inflammatory dermatoses. This review highlights the ability of the biologic agents to treat a wide spectrum of dermatologic diseases.

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Section: Resultsmentioning

confidence: 99%

Off-Label uses of Biologic Agents Approved for Psoriasis and Psoriatic Arthritis for Dermatological Conditions: Part I

Elbendary

Kellen

2016

Journal of Psoriasis and Psoriatic Arthritis

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“…10,11 IFX therapy could be effective for PG patients with RA. 12 Patient 2 and 3 had gangrene with livedo reticularis but no visceral symptoms. In these patients with high levels of RF and CRP, we suspected RV clinically, but no conclusive evidence was obtained.…”

Section: Discussionmentioning

confidence: 96%

“…IFX has been recognized to be effective and safe for IBD‐associated PG and RA with or without RV . IFX therapy could be effective for PG patients with RA …”

Section: Discussionmentioning

confidence: 99%

Clinical analysis of leg ulcers and gangrene in rheumatoid arthritis

Hasegawa

Nagai

Sogabe

et al. 2013

The Journal of Dermatology

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Leg ulcers are often complicated in patients with rheumatoid arthritis (RA), however, the etiology is multifactorial. We examined the cases of leg ulceration or gangrene in seven RA patients who were hospitalized over the past 3 years. One patient was diagnosed as having pyoderma gangrenosum. Although vasculitis was suspected in three patients, no histological evidence was obtained from the skin specimens. In these patients, angiography revealed the stenosis or occlusion of digital arteries. In the remaining three patients, leg ulcers were considered to be due to venous insufficiency. Treatment should be chosen depending on the causes of leg ulcers.

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“…PG has been effectively treated by etanercept in selected cases [Charles et al, 2007;Roy et al, 2006], whereas others have been unsuccessful [Kleinpenning et al, 2010]. Infliximab can improve [Baglieri and Scuder 2010;Tada et al, 2010] or induce [Brunasso et al, 2010] PG in a limited number of patients. Although the exact role of TNF-a in PG remains unknown, chemotaxis of neutrophils controlled in part by TNF alpha may contribute to its pathogenesis.…”

Section: Pyoderma Gangrenosummentioning

confidence: 99%

“…Patients receiving anti-TNF therapy (infliximab, etanercept, or adalimumab) can develop drug-induced cutaneous lupus or cutaneous vasculitis (Moustou et al, 2009). The development of antinuclear antibodies (ANA), antibodies against double-stranded (anti-dsDNA), and single-stranded DNA (anti-ssDNA) Hanauer et al, 2002Adams et al, 2010a Brunasso et al, 2008Miller et al, 2011a Delage et al, 2011Fardet et al, 2007Fernandez-Vozmediano et al, 2007Haslund et al, 2009Mekkes and Bos, 2008Moschella, 2007Sullivan et al, 2003Usmani et al, 2007Alopecia areata Ettefagh et al, 2004Posten et al, 2005Strober et al, 2005Fabre et al, 2008Tosti et al, 2006Garcia Bartels et al, 2006Katoulis et al, 2009Pelivani et al, 2008Pyoderma gangrenosum Charles et al, 2007Brunasso et al, 2010Kleinpenning et al, 2010Roy et al, 2006Baglieri et al, 2010Tada et al, 2010Pemphigus vulgaris Fiorentino et al, 2011a Fiorentino et al, 2011 Double-blind, placebo-controlled, randomized trial.…”

Section: Lupus Erythematosus and Vasculitismentioning

confidence: 99%

Anti‐tumor necrosis factor‐α therapies for immune‐mediated and inflammatory skin diseases

Dessinioti

Stratigos

Katsambas

et al. 2011

Drug Development Research

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Anti-tumor necrosis factor-a (TNF-a) therapies, also called biologic therapies or immunotherapies, are being used increasingly in dermatology, rheumatology, and gastroenterology in the context of established and emerging indications. Anti-TNF agents target TNF-a and include infliximab (a chimeric IgG1 monoclonal antibody), adalimumab (a fully human recombinant IgG1 monoclonal antibody), and etanercept (a dimeric fusion protein of TNFR1 linked to the Fc portion of IgG1). Among skin diseases, only plaque psoriasis represents an approved indication for the use of anti-TNF-a agents; however, anti-TNF therapies have been used as off-label treatments in a plethora of immune-mediated or inflammatory cutaneous disorders, such as hidradenitis suppurativa, alopecia areata, pyoderma gangrenosum, and pemphigus vulgaris. In this short review we present accumulating evidence regarding the dual effect of these therapies in inflammatory skin diseases, either resulting in improvement or acting as a paradoxical trigger for their development. The proposed mechanism of action of anti-TNF treatments on pathogenic key points of these skin conditions is also discussed. Drug Dev Res 72:615-622, 2011. r 2011 Wiley Periodicals, Inc.

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Use of infliximab in a patient with pyoderma gangrenosum and rheumatoid arthritis

Cited by 7 publications

References 28 publications

Off-Label uses of Biologic Agents Approved for Psoriasis and Psoriatic Arthritis for Dermatological Conditions: Part I

Off-Label uses of Biologic Agents Approved for Psoriasis and Psoriatic Arthritis for Dermatological Conditions: Part I

Clinical analysis of leg ulcers and gangrene in rheumatoid arthritis

Anti‐tumor necrosis factor‐α therapies for immune‐mediated and inflammatory skin diseases

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