RESEARCH - Rates of new-onset psoriasis in patients with RA receiving anti-TNF-alpha therapy

[Guest guest]

Ann Rheum Dis. 2008 Apr 2

Rates of new-onset psoriasis in patients with rheumatoid arthritis

receiving anti-TNF{alpha} therapy.

Results from the British Society for Rheumatology Biologics

Register.on MJ, Dixon WG, KD, King Y, Groves R, Hyrich

KL, Symmons DP.

The University of Manchester, United Kingdom.

BACKGROUND: Anti-TNFalpha treatments improve outcome in severe RA and

are efficacious in psoriasis and psoriatic arthritis. However recent

case reports describe psoriasis occurring as an adverse event in RA

patients receiving anti-TNFalpha therapy. OBJECTIVES: We aimed to

determine whether the incidence rate of psoriasis was higher in

patients with RA treated with anti-TNFalpha therapy compared to those

treated with traditional disease modifying anti-rheumatic drugs

(DMARDs). We also compared the incidence rates of psoriasis between

the 3 anti-TNFalpha drugs licensed for RA. METHODS: We studied 9826

anti-TNF-treated and 2880 DMARD-treated patients with severe RA from

The British Society for Rheumatology Biologics Register (BSRBR). All

patients reported with new onset psoriasis as an adverse event were

included in the analysis. Incidence rates of psoriasis were calculated

as events/1000 person years and compared using incidence rate ratios

(IRR). RESULTS: 25 incident cases of psoriasis in patients receiving

anti-TNFalpha therapy and none in the comparison cohort were reported

between January 2001 and July 2007. The absence of any cases in the

comparison cohort precluded a direct comparison; however the crude

incidence rate of psoriasis in those treated with anti-TNFalpha

therapy was elevated at 1.04 (95% CI 0.67, 1.54) per 1,000 person

years compared to the rate of 0 (upper 97.5% CI 0.71) per 1,000 person

years in the DMARD treated patients. Adalimumab-treated patients had a

significantly higher rate of incident psoriasis compared to

etanercept-treated (IRR 4.6 [95% CI 1.7, 12.1]) and infliximab-treated

(IRR 3.5 [95% CI 1.3-9.3]) patients. CONCLUSIONS: Results from this

study suggest that the incidence of psoriasis is increased in patients

treated with anti-TNFalpha therapy. Our findings also suggest that the

incidence may be higher in adalimumab-treated patients.

PMID: 18385277

http://www.ncbi.nlm.nih.gov/pubmed/18385277

--

Not an MD