Re: RESEARCH - TNF blockers may trigger skin lesions

[Guest guest]

:

Wow, this kind of makes me wonder, since I have a

family history of psoriasis, and am on Enbrel, will I

be more likely to develop psoriasis than others? I

really don't need another diagnosis lol.

Kathe in CA

--- <Matsumura_Clan@...> wrote:

> TNF blockers may trigger skin lesions in some

> patients

>

>

> Rheumawire

> Mar 9, 2006

> Gandey

>

> Berlin, Germany - Researchers are hypothesizing that

> tumor-necrosis-factor

> (TNF) blockade may have the unexpected effect of

> prompting new-onset

> psoriasis or aggravating existing disease [1].

> Despite previous evidence

> suggesting that TNF inhibitors significantly reduce

> psoriatic skin lesions,

> senior author Dr Gerd-Rüdiger Burmester

> (Charité-University Medicine,

> Berlin, Germany) and colleagues have published new

> preliminary findings

> suggesting that the opposite may be true for some

> patients. Their work

> appears in the March 2006 issue of the ls of the

> Rheumatic Diseases.

>

> In a small case report, the researchers describe

> nine patients with

> rheumatoid arthritis (RA) treated with different

> types of TNF antagonists

> who unexpectedly developed psoriatic skin lesions.

> " The inhibition of TNF-

> [may have] influenced the manifestation of psoriasis

> skin lesions in our

> patients, " write the researchers, led by Dr Sonja

> Kary (Charité-University

> Medicine). " As far as we know, this is the first

> demonstration of either a

> new onset or an exacerbation of psoriatic skin

> lesions during anti-TNF-

> treatment. "

>

> The researchers report that an additional literature

> search revealed

> sporadic information on psoriasis and psoriasislike

> symptoms in patients

> treated with TNF blockers for inflammatory bowel

> disease, ankylosing

> spondylitis, and RA.

>

> They found that withdrawal or dose reduction of

> TNF-blocking agents led to

> improvement only in some patients and was generally

> limited by the activity

> of the underlying RA. A change within the substance

> class reduced the

> severity of the symptoms in some patients, but the

> researchers found that

> they could not predict which biological agent would

> prove to be less

> harmful.

>

> They looked at two monoclonal antibodies-infliximab

> (Remicade, Centocor) and

> adalimumab (Humira, Abbott)-as well as the receptor

> construct etanercept

> (Enbrel, Amgen/Wyeth). They note that all three TNF

> blockers have been shown

> to be effective in psoriatic skin disease in

> clinical trials and etanercept

> in particular has been approved for this indication.

>

> Kary and colleagues note that a hypothetical

> explanation for the appearance

> or deterioration of psoriasis might be the overall

> enhanced susceptibility

> to bacterial infections caused by TNF inhibition,

> but, they point out, none

> of the patients had a preceding bacterial infection.

>

> The researchers contend that RA patients rarely

> present with psoriasis of

> the skin. They point to the unpublished German

> national data bank for

> rheumatological diseases, which shows that only 26

> out of more than 11 400

> patients with definite RA simultaneously had

> psoriasis.

>

> The investigators conclude, " A study of such

> patients with new onset or

> aggravation of psoriasis during TNF- blockade will

> be continued for further

> analysis of an underlying common pattern. "

>

>

> Source

>

> 1. Kary S, Worm M, Audring H, et al.

> New onset or

> exacerbation of psoriatic skin lesions in patients

> with definite rheumatoid

> arthritis receiving tumour necrosis factor alpha

> antagonists. Ann Rheum Dis

> 2006; 65:405-407.

>

>

>

>

> Not an MD

>

> I'll tell you where to go!

>

> Mayo Clinic in Rochester

> http://www.mayoclinic.org/rochester

>

> s Hopkins Medicine

> http://www.hopkinsmedicine.org

>

>

Kathe

" To ride a horse is to borrow freedom. "

__________________________________________________

[Guest guest]

I wouldn't worry about it too much, Kathe. So far, relative to the large

number of people using the anti-TNF biologics, there have only been a small

number of reports of this happening. Of course, it would be nice if they

could figure out who would be most susceptible to this kind of unfortunate

development.

In the meanwhile, be sure to report any new rash to your rheumatologist

promptly.

Not an MD

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org

Re: [ ] RESEARCH - TNF blockers may trigger skin lesions

> :

>

> Wow, this kind of makes me wonder, since I have a

> family history of psoriasis, and am on Enbrel, will I

> be more likely to develop psoriasis than others? I

> really don't need another diagnosis lol.

>

> Kathe in CA