Development of psoriasis in IBD patients under TNF-antagonist therapy is associated neither with anti-TNF-antagonist antibodies nor trough levels. (1st December 2016)

• Record Type: Journal Article
• Authors: Protic, Marijana; Schoepfer, Alain; Yawalkar, Nikhil; Vavricka, Stephan; Seibold, Frank
• Is Part Of: Scandinavian journal of gastroenterology. Volume 51:Number 12(2016)
• Page Start: 1482
• Page End: 1488
• Publication Date: 2016-12-01
• Subjects: Psoriasis -- infliximab -- adalimumab -- certolizumab pegol -- inflammatory bowel disease -- Crohn's disease -- ulcerative colitis; Gastroenterology -- Periodicals; Digestive organs -- Diseases -- Periodicals; 616.33
• DOI: 10.1080/00365521.2016.1218541
• Languages: English
• ISSNs: 0036-5521

Abstract

Abstract: Background: The cause of anti-TNF-induced psoriasis is still unknown. Objective: We aimed to evaluate if the appearance of psoriasis under anti-TNF therapy is associated with anti-TNF antibody levels and TNF-antagonist trough levels. Methods: In this case-control study we identified 23 patients (21 with Crohn's disease [CD], two with ulcerative colitis [UC]) who developed psoriasis under infliximab (IFX, n = 20), adalimumab (ADA, n = 2), and certolizumab pegol (CZP, n = 1) and compared them regarding the anti-TNF-antagonist antibody levels with 85 IBD patients (72 with CD, 13 with UC) on anti-TNF therapy without psoriasis. Results: Median disease duration was not different between the two groups (7 years in the group with psoriasis under TNF-antagonists vs. 10 years in the control group, p = 0.072). No patient from the psoriasis group had antibodies against TNF-antagonists compared to 10.6% in the control group ( p = 0.103). No difference was found in IFX trough levels in the group of patients with psoriasis compared to the control group (2.6 μg/mL [IQR 0.9–5.5] vs. 3.4 μg/mL [IQR 1.4–8.1], p = 0.573). TNF-antagonist therapy could be continued in 91.3% of patients with TNF-antagonist related psoriasis and most patients responded to topical therapies. Conclusion: Anti-TNF-induced psoriasis seems to be independent of anti-TNF antibodies and trough levels. Interruption of Anti-TNF therapy is rarely necessary.