Limited Effectiveness of IL-17 Inhibitors for Anti-TNF-Induced Psoriasis in Hidradenitis Suppurativa

Background: Paradoxical psoriasis (PP) is a known adverse event of anti-tumor necrosis factor (anti-TNF) agents in hidradenitis suppurativa (HS), yet evidence regarding its management remains limited. The objective was to assess the effectiveness of interleukin-17 inhibitors (IL-17i) in treating ant...

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Detalles Bibliográficos
Autores: Bascón, Leonardo|||0000-0001-9621-8538, Lluch-Galcerá, Juan José|||0000-0002-8373-4303, Mora Fernández, Verónica|||0000-0003-0016-9781, Verdaguer-Faja, Júlia|||0000-0002-9482-1621, Haselgruber, Sofía|||0000-0002-8432-0954, Molina-Leyva, Alejandro|||0000-0001-6882-2113, Sin-Soler, Maria, Garbayo-Salmons, Patricia|||0000-0003-3325-6785, Mercader Salvans, Jùlia, Lukoviek Araya, Vania, Fernández-Crehuet, Pablo, Parra-Navarro, Laura, Martin-Ezquerra, Gemma|||0000-0002-5106-7526, Carrascosa, José Manuel|||0000-0003-4266-0771, Sampayo-Cordero, Miguel, Romaní, Jorge|||0000-0002-6134-5155, Guilabert-Vidal, Antonio
Tipo de recurso: artículo
Fecha de publicación:2026
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:dnet:uabarcelona_::a18de6d4ca07d640439a46c7022dadff
Acceso en línea:https://ddd.uab.cat/record/328517
https://dx.doi.org/urn:doi:10.1111/ijd.70420
Access Level:acceso embargado
Palabra clave:Biologic therapy
Paradoxical drug reactions
Paradoxical psoriasis
Hidradenitis suppurativa
Tumour necrosis factor-alpha inhibitors
Interleukin-17 inhibitors
IHS4
Physician's global assessment
Descripción
Sumario:Background: Paradoxical psoriasis (PP) is a known adverse event of anti-tumor necrosis factor (anti-TNF) agents in hidradenitis suppurativa (HS), yet evidence regarding its management remains limited. The objective was to assess the effectiveness of interleukin-17 inhibitors (IL-17i) in treating anti-TNF-induced PP in patients with HS. Methods: This multicenter retrospective study included 40 adults with HS who developed PP during anti-TNF therapy and were subsequently treated with IL-17i. Outcomes for PP were measured using the Physician's Global Assessment (PGA); HS severity was evaluated using the International Hidradenitis Suppurativa Severity Score System (IHS4) and Hurley scores. Paired comparisons were performed using the Wilcoxon signed-rank or McNemar's test, as appropriate. Multivariate analysis was performed using LASSO-regularized logistic regression. Missing data were managed by multiple imputation. Results: Of the patients, 27.5% achieved a clinically meaningful PP response, while 45% experienced worsening. Female sex, older age at HS onset, and prior exposure to secukinumab were associated with nonresponse. Conversely, HS severity improved significantly in 70% of patients (p < 0.001). Conclusions: IL-17i showed limited effectiveness for anti-TNF-induced PP in HS, though improvement in hidradenitis was observed.

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