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

Sanz Segura, Patricia (Universidad de Zaragoza) ; Gomollón, Fernando (Universidad de Zaragoza) ; Casas, Diego (Universidad de Zaragoza) ; 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 (Universidad de Zaragoza) ; 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 (Universidad de Zaragoza)

Resumen: Background
some patients with inflammatory bowel disease (IBD) treated with antiTNF develop drug-induced psoriasis (antiTNF-IP). Several therapeutic strategies are possible.

Aims
to assess the management of antiTNF-IP in IBD, and its impact in both diseases.

Methods
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.

Results
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.

Conclusion
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.

Idioma: Inglés

DOI: 10.1016/j.dld.2024.05.021

Año: 2024

Publicado en: DIGESTIVE AND LIVER DISEASE 56, 12 (2024), 2060-2068
ISSN: 1590-8658

Tipo y forma: Artículo (PostPrint)

Área (Departamento): Area Medicina (Dpto. Medicina, Psiqu. y Derm.)