Psoriasis induced by antiTNF therapy in inflammatory bowel disease: Therapeutic management and evolution of both diseases in a nationwide cohort study.
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Ошибки и ограничения
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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, ENEIDA project of GETECCU
Аннотация
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.