Induction or exacerbation of psoriatic lesions during anti-TNF-α therapy for inflammatory bowel disease: A systematic literature review based on 222 cases

Background: Paradoxical cases of psoriatic lesions induced or exacerbated by anti-tumor necrosis factor (TNF)-α therapy have been reported more frequently in recent years, but data related to inflammatory bowel disease (IBD) are rare. A systematic literature review was performed to provide informati...

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Detalles Bibliográficos
Autores: Denadai, Rafael [UNESP], Teixeira, Fábio Vieira [UNESP], Steinwurz, Flavio, Romiti, Ricardo, Saad-Hossne, Rogério [UNESP]
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2013
País:Brasil
Institución:Universidade Estadual Paulista (UNESP)
Repositorio:Repositório Institucional da UNESP
Idioma:inglés
OAI Identifier:oai:repositorio.unesp.br:11449/74167
Acceso en línea:http://dx.doi.org/10.1016/j.crohns.2012.08.007
http://hdl.handle.net/11449/74167
Access Level:acceso abierto
Palabra clave:Adalimumab;
Biological therapy
Certolizumab;
Inflammatory bowel disease;
Infliximab;
Psoriasis;
adalimumab
azathioprine
certolizumab pegol
corticosteroid
etanercept
infliximab
mesalazine
methotrexate
tumor necrosis factor alpha inhibitor
Crohn disease
drug withdrawal
enteritis
human
priority journal
psoriasis
pustulosis palmoplantaris
review
skin manifestation
spondylarthritis
systematic review
Descripción
Sumario:Background: Paradoxical cases of psoriatic lesions induced or exacerbated by anti-tumor necrosis factor (TNF)-α therapy have been reported more frequently in recent years, but data related to inflammatory bowel disease (IBD) are rare. A systematic literature review was performed to provide information about this adverse effect in patients with IBD who receive anti-TNF therapy. Methods: Published studies were identified by a search of Medline, Embase, Cochrane, SciELO, and LILACS databases. Results: A total of 47 studies (222 patients) fulfilled the inclusion criteria and were selected for analysis. Clinical and therapeutic aspects varied considerably among these reports. Of the 222 patients, 78.38% were diagnosed with Crohn's disease, and 48.20% were female. The mean patient age was 26.50. years, and 70.72% of patients had no history of psoriasis. Patients developed psoriasiform lesions (55.86%) more often than other types of psoriatic lesions, and infliximab was the anti-TNF-α therapy that caused the cutaneous reaction in most patients (69.37%). Complete remission of cutaneous lesions was observed in 63.96% of the cases. Conclusions: We found that psoriatic lesions occurred predominantly in adult patients with Crohn's disease who received infliximab and had no previous history of psoriasis. Most patients can be managed conservatively without discontinuing anti-TNF-α therapy. © 2012 European Crohn's and Colitis Organisation.