Annals of internal medicine · 2015
Characteristics of Skin Lesions Associated With Anti-Tumor Necrosis Factor Therapy in Patients With Inflammatory Bowel Disease: A Cohort Study.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Cleynen Isabelle, Van Moerkercke Wouter, Billiet Thomas, Vandecandelaere Pieter, Vande Casteele Niels, Breynaert Christine, Ballet Vera, Ferrante Marc, Noman Maja, Assche Gert Van, Rutgeerts Paul, van den Oord Joost J, Gils Ann, Segaert Siegfried, Vermeire Séverine
Аннотация
BACKGROUND: A subgroup of patients with inflammatory bowel disease (IBD) treated with anti-tumor necrosis factor (TNF) antibodies develop skin lesions, but the lesions and their clinical course are not well-characterized.
OBJECTIVE: To describe patients treated with anti-TNF antibodies who did and did not develop skin lesions.
DESIGN: Retrospective cohort.
SETTING: Single IBD tertiary referral center.
PATIENTS: 917 consecutive patients with IBD who initiated anti-TNF therapy.
MEASUREMENTS: Skin lesions, patient demographic characteristics, treatments, clinical course, and serologic and genetic markers.
RESULTS: During a median follow-up of 3.5 years (interquartile range [IQR], 0.5 to 7.4 years), skin lesions associated with the use of anti-TNF therapy developed in 264 of 917 (29%) patients (psoriasiform eczema, 30.6%; eczema, 23.5%; xerosis cutis, 10.6%; palmoplantar pustulosis, 5.3%; psoriasis, 3.8%; other, 26.1%). Lesions typically developed at flexural regions, genitalia, and the scalp, especially the psoriasiform lesions. Thirty-one percent of women and 26% of men developed lesions. Median cumulative doses (2864 mg/y [IQR, 2203 to 3819 mg/y] and 2927 mg/y [IQR, 2377 to 3667 mg/y]) and trough levels (4.2 µg/mL [IQR, 2.6 to 5.8 µg/mL] and 4.0 µg/mL [IQR, 1.6 to 5.9 µg/mL]) of infliximab were similar in patients with and without lesions. All but 28 patients (11%) were successfully managed without needing to stop therapy because of lesions.
LIMITATION: Retrospective nature and no matched control group of patients not receiving anti-TNF therapy.
CONCLUSION: Skin lesions occur frequently in association with anti-TNF therapy but rarely require discontinuation of therapy. Close surveillance and early referral to a dedicated dermatologist are recommended.
PRIMARY FUNDING SOURCE: Research Foundation Flanders (FWO), Belgium; Geconcerteerde Onderzoekacties of KU Leuven; and Janssen Biologics.
OBJECTIVE: To describe patients treated with anti-TNF antibodies who did and did not develop skin lesions.
DESIGN: Retrospective cohort.
SETTING: Single IBD tertiary referral center.
PATIENTS: 917 consecutive patients with IBD who initiated anti-TNF therapy.
MEASUREMENTS: Skin lesions, patient demographic characteristics, treatments, clinical course, and serologic and genetic markers.
RESULTS: During a median follow-up of 3.5 years (interquartile range [IQR], 0.5 to 7.4 years), skin lesions associated with the use of anti-TNF therapy developed in 264 of 917 (29%) patients (psoriasiform eczema, 30.6%; eczema, 23.5%; xerosis cutis, 10.6%; palmoplantar pustulosis, 5.3%; psoriasis, 3.8%; other, 26.1%). Lesions typically developed at flexural regions, genitalia, and the scalp, especially the psoriasiform lesions. Thirty-one percent of women and 26% of men developed lesions. Median cumulative doses (2864 mg/y [IQR, 2203 to 3819 mg/y] and 2927 mg/y [IQR, 2377 to 3667 mg/y]) and trough levels (4.2 µg/mL [IQR, 2.6 to 5.8 µg/mL] and 4.0 µg/mL [IQR, 1.6 to 5.9 µg/mL]) of infliximab were similar in patients with and without lesions. All but 28 patients (11%) were successfully managed without needing to stop therapy because of lesions.
LIMITATION: Retrospective nature and no matched control group of patients not receiving anti-TNF therapy.
CONCLUSION: Skin lesions occur frequently in association with anti-TNF therapy but rarely require discontinuation of therapy. Close surveillance and early referral to a dedicated dermatologist are recommended.
PRIMARY FUNDING SOURCE: Research Foundation Flanders (FWO), Belgium; Geconcerteerde Onderzoekacties of KU Leuven; and Janssen Biologics.