Dixon, W G

Groves, R

Harrison, M J

Hyrich, K L

King, Y

Symmons, D P M

Watson, K D

English

PubMed

M J Harrison

W G Dixon

K D Watson

Y King

R Groves

K L Hyrich

D P M Symmons

Crossref

Rates of new-onset psoriasis in patients with rheumatoid arthritis receiving anti-tumour necrosis factor α therapy: results from the British Society for Rheumatology Biologics Register

Background: Anti-tumour necrosis factor (TNF)a treatments improve outcome in severe rheumatoid arthritis (RA) and are efficacious in psoriasis and psoriatic arthritis. However recent case reports describe psoriasis occurring as an adverse event in patients with RA receiving anti- TNFa therapy. Objectives: We aimed to determine whether the incidence rate of psoriasis was higher in patients with RA treated with anti-TNFα therapy compared to those treated with traditional disease-modifying antirheumatic drugs (DMARDs). We also compared the incidence rates of psoriasis between the three anti-TNFa 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 Biologies 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: In all, 25 incident cases of psoriasis in patients receiving anti-TNFα 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-TNFα therapy was elevated at 1.04 (95% CI 0.67 to 1.54) per 1000 person years compared to the rate of 0 (upper 97.5% CI 0.71) per 1000 person years in the patients treated with DMARDs. Patients treated with adalimumab had a significantly higher rate of incident psoriasis compared to patients treated with etanercept (IRR 4.6,95% CI 1.7 to 12.1) and infliximab (IRR 3.5, 95% C11.3 to 9.3). Conclusions: Results from this study suggest that the incidence of psoriasis is increased in patients treated with anti-TNFα therapy. Our findings also suggest that the incidence may be higher in patients treated with adalimumab

Harrison, M. J.

Dixon, W. G.

Watson, K. D.

King, Y.

Groves, R.

Hyrich, K. L.

Symmons, D. P M

The University of Manchester - Institutional Repository

Rates of new-onset psoriasis in patients with rheumatoid arthritis receiving anti-tumour necrosis factor α therapy: Results from the British Society for Rheumatology Biologies Register

Background: Anti-tumour necrosis factor (TNF)alpha treatments improve outcome in severe rheumatoid arthritis (RA) and are efficacious in psoriasis and psoriatic arthritis. However recent case reports describe psoriasis occurring as an adverse event in patients with RA receiving anti-TNF alpha therapy. Objectives: We aimed to determine whether the incidence rate of psoriasis was higher in patients with RA treated with anti-TNF alpha therapy compared to those treated with traditional disease-modifying antirheumatic drugs (DMARDs). We also compared the incidence rates of psoriasis between the three anti-TNF alpha 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: In all, 25 incident cases of psoriasis in patients receiving anti-TNF alpha 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-TNFa therapy was elevated at 1.04 (95% CI 0.67 to 1.54) per 1000 person years compared to the rate of 0 (upper 97.5% CI 0.71) per 1000 person years in the patients treated with DMARDs. Patients treated with adalimumab had a significantly higher rate of incident psoriasis compared to patients treated with etanercept (IRR 4.6, 95% CI 1.7 to 12.1) and infliximab (IRR 3.5, 95% CI 1.3 to 9.3). Conclusions: Results from this study suggest that the incidence of psoriasis is increased in patients treated with anti-TNF alpha therapy. Our findings also suggest that the incidence may be higher in patients treated with adalimumab

Symmons, D. P. M.

King's Research Portal

Rates of new-onset psoriasis in patients with rheumatoid arthritis receiving anti-tumour necrosis factor alpha therapy: results from the British Society for Rheumatology Biologics Register

A global phase III randomized controlled trial of etanercept in psoriasis: safety, efficacy, and effect of dose reduction.

A medical conundrum: onset of psoriasis in patients receiving anti-tumour necrosis factor agents. Ann Rheum Dis

Acute generalized exanthematous pustulosis associated with pseudoephedrine.

Adalimumab, a fully human anti-tumor necrosis factor a monoclonal antibody, for the treatment of rheumatoid arthritis in patients taking concomitant methotrexate: the ARMADA trial. Arthritis Rheum

Anti-TNF-a-induced psoriasis: case report of an unusual adverse event.

Anti-tumor necrosis factor-a-induced psoriasis.

British Society for Rheumatology Biologics Register. Ann Rheum Dis 2003;62(Suppl 2):ii28–9.

British Society for Rheumatology Standards GaAWG. Update on the British Society for Rheumatology guidelines for prescribing TNFa blockers in adults with rheumatoid arthritis (update of previous guidelines of

Cross-regulation of TNF and IFN-a in autoimmune diseases.

Depressed Langerhans cell migration and reduced contact hypersensitivity response in mice lacking TNF receptor p75.

Dermatological conditions during TNF-a-blocking therapy in patients with rheumatoid arthritis: a prospective study. Arthritis Res Ther

Etanercept therapy in rheumatoid arthritis. A randomized, controlled trial.

Guideline for anti-TNF-a therapy in psoriatic arthritis.

Infliximab (chimeric anti-tumour necrosis factor a monoclonal antibody) versus placebo in rheumatoid arthritis patients receiving concomitant methotrexate: a randomised phase III trial.

Infliximab can precipitate as well as worsen palmoplantar pustulosis: possible linkage to the expression of tumour necrosis factor-a in the normal palmar eccrine sweat duct?

Infliximab induction therapy for patients with severe plaque-type psoriasis: a randomized, double-blind, placebo-controlled trial.

Modified disease-activity scores that include 28-joint counts – development and validation in a prospective longitudinal-study of patients with rheumatoid-arthritis. Arthritis Rheum

modifiedto assess disability in British patients with rheumatoid arthritis.

New onset or exacerbation of psoriatic skin lesions in patients with definite rheumatoid arthritis receiving tumour necrosis factor a antagonists. Ann Rheum Dis

New-onset psoriatic palmoplantaris pustulosis following infliximab therapy: a class effect?

Onset of psoriasis during treatment with TNF-a antagonists: a report of 3 cases.

Psoriasis and pustular dermatitis triggered by TNF-a inhibitors in patients with rheumatologic conditions. Arch Dermatol

Psoriasis induced by anti-tumor necrosis factor therapy: a paradoxical adverse reaction. Arthritis Rheum

Psoriasis induced by tumor necrosis factor-a antagonist therapy: a case series.

Psoriatic lesions induced by antitumour necrosis factor-a treatment: two cases.

Pustular skin lesions in patients treated with infliximab: report of two cases.

Skin reaction to adalimumab. Arthritis Rheum

Stata statistical software. College Station,

The appearance of pustular psoriasis during antitumor necrosis factor therapy.

The spondyloarthritides. In: Fauci

The transfer of a laboratory based hypothesis to a clinically useful therapy: the development of antiTNF therapy of rheumatoid arthritis. Best Pract Res Clin Rheumatol

The yin and yang of TNF-a inhibition.

TNFa therapy in psoriatic arthritis and psoriasis. Ann Rheum Dis

Tumour necrosis factor a is pro-inflammatory in normal human skin and modulates cutaneous adhesion molecule expression.

Unexpected onset of psoriasis during infliximab treatment: comment on the article by Beuthien et al. Arthritis Rheum

vanGestelAM,HaagsmaCJ,vanRielPL.Validationofrheumatoidarthritisimprovement criteria that include simplified joint counts. Arthritis Rheum

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Rates of new-onset psoriasis in patients with rheumatoid arthritis receiving anti-tumour necrosis factor α therapy: results from the British Society for Rheumatology Biologics Register

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