Psoriasis induced by antiTNF therapy in inflammatory bowel disease: Therapeutic management and evolution of both diseases in a nationwide cohort study

• Published in: Digestive and liver disease 2024-12, Vol.56 (12), p.2060-2068
• Main Authors: Sanz Segura, Patricia, Gomollón, Fernando, Casas, Diego, Iborra, Marisa, Vela, Milagros, Fernández-Clotet, Agnès, Muñoz, Roser, García de la Filia, Irene, García Prada, María, Ferrer Rosique, Juan Ángel, García, María José, de Francisco, Ruth, Arias, Lara, Barrio, Jesús, Guerra, Iván, Ponferrada, Ángel, Gisbert, Javier P., Carrillo-Palau, Marta, Calvet, Xavier, Márquez-Mosquera, Lucía, Gros, Beatriz, Cañete, Fiorella, Monfort, David, Madrigal Domínguez, Rosa Eva, Roncero, Óscar, Laredo, Viviana, Montoro, Miguel, Muñoz, Carmen, López-Cauce, Beatriz, Lorente, Rufo, Fuentes Coronel, Ana, Vega, Pablo, Martín, Dolores, Peña, Elena, Varela, Pilar, Olivares, Sonsoles, Pajares, Ramón, Lucendo, Alfredo J., Sesé, Eva, Botella Mateu, Belén, Nos, Pilar, Domènech, Eugeni, García-López, Santiago
• Format: Article
• Language: English
• Subjects: Adalimumab - adverse effects; Adalimumab - therapeutic use; Adult; Anti-tumour necrosis factor α; Cohort Studies; Female; Humans; Inflammatory bowel disease; Inflammatory Bowel Diseases - drug therapy; Infliximab - adverse effects; Infliximab - therapeutic use; Italy; Male; Middle Aged; Multivariate Analysis; Psoriasis - drug therapy; Psoriasis induced by antiTNF; Registries; Severity of Illness Index; Tumor Necrosis Factor-alpha - antagonists & inhibitors; Ustekinumab - adverse effects; Ustekinumab - therapeutic use
• ISSN: 1590-8658; 1878-3562; 1878-3562
• DOI: 10.1016/j.dld.2024.05.021

some patients with inflammatory bowel disease (IBD) treated with antiTNF develop drug-induced psoriasis (antiTNF-IP). Several therapeutic strategies are possible. to assess the management of antiTNF-IP in IBD, and its impact in both diseases. patients with antiTNF-IP from ENEIDA registry were included. Therapeutic strategy was classified as continuing the same antiTNF, stopping antiTNF, switch to another antiTNF or swap to a non-antiTNF biologic. IP severity and IBD activity were assessed at baseline and 16, 32 and 54 weeks. 234 patients were included. At baseline, antiTNF-IP was moderate-severe in 60 % of them, and IBD was in remission in 80 %. Therapeutic strategy was associated to antiTNF-IP severity (p < 0.001). AntiTNF-IP improved at week 54 with all strategies, but continuing with the same antiTNF showed the worst results (p = 0.042). Among patients with IBD in remission, relapse was higher in those who stopped antiTNF (p = 0.025). In multivariate analysis, stopping antiTNF, trunk and palms and soles location were associated with antiTNF-IP remission; female sex and previous surgery in Crohn´s disease with IBD relapse. skin lesions severity and IBD activity seem to determine antiTNF-IP management. Continuing antiTNF in mild antiTNF-IP, and swap to ustekinumab or switch to another antiTNF in moderate-severe cases, are suitable strategies.