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Zhou Y, Hu Z. Membranous lupus nephritis secondary to secukinumab therapy: A case report and literature review. Lupus 2024; 33:644-649. [PMID: 38569663 DOI: 10.1177/09612033241242698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Abstract
The interleukin (IL)-17 axis is involved in many inflammatory and autoimmune diseases. Secukinumab, an IL-17 inhibitor, has been approved for psoriasis treatment. There are accumulating cases of lupus erythematosus induced by IL-17 inhibition. Lupus nephritis after IL-17 inhibition has not been reported. We report the case of a 57-year-old man who developed membranous lupus nephritis after secukinumab treatment for psoriasis. Anti-SSA and PM-Scl antibodies were positive. dsDNA, anti-Smith, and anti-histone antibodies were negative, and serum complement was low. Secukinumab was discontinued, while tacrolimus was initiated, subsequently switched to cyclosporin, belimumab, glucocorticosteroid, and hydroxychloroquine with a good response. The relationship between lupus erythematosus and IL-17 inhibition requires further research.
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Affiliation(s)
- Yi Zhou
- Department of Nephrology, West China Hospital, Sichuan University, Chengdu, China
| | - Zhangxue Hu
- Department of Nephrology, West China Hospital, Sichuan University, Chengdu, China
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2
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A Review of the Safety of Interleukin-17A Inhibitor Secukinumab. Pharmaceuticals (Basel) 2022; 15:ph15111365. [PMID: 36355537 PMCID: PMC9695424 DOI: 10.3390/ph15111365] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 10/28/2022] [Accepted: 11/02/2022] [Indexed: 11/09/2022] Open
Abstract
Secukinumab is an anti-interleukin (IL)-17A IgG1-κ monoclonal antibody approved for psoriasis, psoriatic arthritis, and ankylosing spondylitis. Its efficacy is well documented, but the complete safety profile of secukinumab, especially on long-term use, needs to be studied. IL-17 inhibitors increase the risk of infections, especially respiratory tract infections and candidiasis, and inflammatory bowel disease; the causal relationships are well described. However, evidence regarding the other adverse events is scarce, and causal associations between the adverse events and the biologic remain unresolved. This review aims to present a narrative perspective on the safety of secukinumab and identify some key areas where the safety of secukinumab may potentially be useful in understanding the scope of secukinumab therapy and making informed clinical decisions.
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3
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Liang J, Zhang S, Li Q, Yu Y, Chen X, Zhang X. Review of secukinumab-induced adverse events of special interest and its potential pathogenesis. Dermatol Ther 2022; 35:e15599. [PMID: 35614844 DOI: 10.1111/dth.15599] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 05/10/2022] [Accepted: 05/22/2022] [Indexed: 11/27/2022]
Abstract
Although secukinumab has demonstrated high efficacy and favorable safety in moderate-to-severe psoriasis and psoriatic arthritis, patients developing adverse events of special interest (AESI) were reported increasingly in real-world practice. A systematic literature search of the PubMed database was conducted to identify clinical studies or case reports on secukinumab-induced AESI. More than 1077 patients (aged 18-74 years) from 55 studies were reported to have 24 AESI 3 days to 96 weeks after secukinumab treatment. The four most common AESI was inflammatory bowel disease (n > 1000), eczematous drug eruption (n > 30), drug-associated vasculitis (n = 8), and drug-induced lupus erythematosus (n = 4). Most of these AESI were only mild to moderately severe and resolved after secukinumab discontinuation without or with symptomatic treatment. Secukinumab has the potential to develop a number of AESI by probably dysregulating the different expression of polar T-cell axes (Th1, Th2, Th17, Th22, and/or Treg) and driving various cytokines in some patients. Physicians should be aware of these AESI for timely diagnosis and proper treatment. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Jingyao Liang
- Institute of Dermatology, Guangzhou Medical University, Guangzhou, P.R. China.,Department of Dermatology, Guangzhou Institute of Dermatology, Guangzhou, P.R. China
| | - Sanquan Zhang
- Institute of Dermatology, Guangzhou Medical University, Guangzhou, P.R. China.,Department of Dermatology, Guangzhou Institute of Dermatology, Guangzhou, P.R. China
| | - Qian Li
- Institute of Dermatology, Guangzhou Medical University, Guangzhou, P.R. China.,Department of Dermatology, Guangzhou Institute of Dermatology, Guangzhou, P.R. China
| | - Yihui Yu
- Institute of Dermatology, Guangzhou Medical University, Guangzhou, P.R. China.,Department of Dermatology, Guangzhou Institute of Dermatology, Guangzhou, P.R. China
| | - Xiaoyin Chen
- Institute of Dermatology, Guangzhou Medical University, Guangzhou, P.R. China.,Department of Dermatology, Guangzhou Institute of Dermatology, Guangzhou, P.R. China
| | - Xibao Zhang
- Institute of Dermatology, Guangzhou Medical University, Guangzhou, P.R. China.,Department of Dermatology, Guangzhou Institute of Dermatology, Guangzhou, P.R. China
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4
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Messina F, Piaserico S. The dark side of the moon: the immune-mediated adverse events of IL-17A/IL-17R inhibition. J DERMATOL TREAT 2022; 33:2443-2454. [PMID: 35393910 DOI: 10.1080/09546634.2022.2062281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
As aberrant IL-17 signaling plays a critical role in the pathogenesis of psoriasis, biologic agents targeting this pathway have become an important weapon against this disease. Some biologic agents such as IL-17 inhibitors (secukinumab and ixekizumab) and the IL-17 receptor (IL17R) inhibitor (brodalumab) are relatively safe, tolerable and efficacious drugs. Nevertheless, side effects of IL-17 pathway inhibition occur. This review focuses on the dermatological manifestations linked to these treatments. Paradoxical psoriasis and atopic-like eczema may be the most common cutaneous adverse events, while manifestations such as neutrophilic dermatoses, hypersensitivity reactions, lichenoid eruptions, vasculitides, bullous diseases, lupus-like reactions, pigmentation disorders, adnexal diseases and granulomatous dermatoses have been described less frequently.
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Affiliation(s)
- Francesco Messina
- Dermatology Unit, Department of Medicine, University of Padua, Padua, Italy
| | - Stefano Piaserico
- Dermatology Unit, Department of Medicine, University of Padua, Padua, Italy
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5
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Skudalski L, Shahriari N, Torre K, Santiago S, Bibb L, Kodomudi V, Grant-Kels JM, Lu J. Emerging Therapeutics in the Management of Connective Tissue Disease. Part I. Lupus Erythematosus and Sjögren's Syndrome. J Am Acad Dermatol 2022; 87:1-18. [PMID: 35202775 DOI: 10.1016/j.jaad.2021.12.067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 12/01/2021] [Accepted: 12/04/2021] [Indexed: 11/16/2022]
Abstract
The management of connective tissue diseases is dramatically evolving with the advent of biologics and novel oral systemic therapeutics. Despite involvement in the care of these complex patients, there is a knowledge gap in the field of dermatology regarding these emerging agents. The first article in this continuing medical education series discusses new and emerging therapeutics for lupus erythematosus and Sjögren's syndrome that target cells, intracellular signaling pathways, and cytokines.
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Affiliation(s)
| | - Neda Shahriari
- Department of Dermatology, Brigham and Women's Hospital; Harvard Medical School, Boston, MA
| | - Kristin Torre
- Department of Dermatology, University of Connecticut Health Center, Farmington, CT
| | - Sueheidi Santiago
- Department of Dermatology, University of Connecticut Health Center, Farmington, CT
| | - Lorin Bibb
- Department of Dermatology, University of Connecticut Health Center, Farmington, CT
| | - Vijay Kodomudi
- Department of Dermatology, University of Connecticut Health Center, Farmington, CT
| | - Jane M Grant-Kels
- Department of Dermatology, University of Connecticut Health Center, Farmington, CT
| | - Jun Lu
- Department of Dermatology, University of Connecticut Health Center, Farmington, CT.
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6
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Kremenevski I, Sander O, Sticherling M, Raithel M. Paradoxical Reactions to Biologicals in Chronic Inflammatory Systemic Diseases. DEUTSCHES ARZTEBLATT INTERNATIONAL 2022; 119:88-95. [PMID: 34939919 DOI: 10.3238/arztebl.m2022.0067] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 07/01/2021] [Accepted: 11/24/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Biological agents that contain substances affecting the immune system are increasingly being used to treat chronic inflammatory systemic diseases. Aside from the expected adverse effects, they can also induce unexpected paradoxical reactions (PR). A reaction is called paradoxical when a substance that is generally therapeutically effective induces the opposite of what is intended, with the new appearance or exacerbation of inflammatory changes in the skin and other organs. METHODS The paradoxical reactions that have been described since 1997 are presented here on the basis of the available literature on the main types of chronic inflammatory systemic disease, which was retrieved by a selective search in the PubMed and Google Scholar databases. RESULTS Many studies and registers to date contain no mention of paradoxical reactions. Anti- TNF-alpha treatment for patients with ankylosing spondylitis leads to paradoxical reactions in 19 per 1000 patient years, compared to 11 per 1000 patient years with conventional treatment; the corresponding frequency for paradoxical psoriasis in patients with other chronic inflammatory systemic diseases are 1.04-3.68 versus 1.45 per 1000 patient years. Paradoxical reactions tend to be more common with anti-TNF-alpha treatment than, for example, with the administration of ustekinumab, vedolizumab, and other agents. It is unclear whether some drugs have been noted to cause PR more commonly than others because of varying times since their approval, differences in immunogenicity, and differences between their target structures. CONCLUSION Paradoxical reactions induced by biological agents are a problem confronting physicians in multiple specialties. They need to be distinguished from infectious and neoplastic diseases and from autoimmune conditions of other types. The treatment options for paradoxical reactions include local treatment, symptomatic therapy, prednisolone administration, and the discontinuation or switching of the biological agent, although some patients will react with a further paradoxical reaction to a different biological agent that is used instead.
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7
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Koller-Smith L, Oakley S. Secukinumab-induced systemic lupus erythematosus occurring in a patient with ankylosing spondylitis. Rheumatology (Oxford) 2021; 61:e146-e147. [PMID: 34919658 DOI: 10.1093/rheumatology/keab918] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 11/16/2021] [Accepted: 12/06/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Louise Koller-Smith
- Department of Rheumatology, John Hunter Hospital, New Lambton Heights, New South Wales, Australia
| | - Stephen Oakley
- Department of Rheumatology, John Hunter Hospital, New Lambton Heights, New South Wales, Australia.,School of Medicine, University of Newcastle, Newcastle, New South Wales, Australia
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8
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Kaler J, Kaeley GS. Secukinumab-Induced Lupus Erythematosus: A Case Report and Literature Review. J Clin Rheumatol 2021; 27:S753-S754. [PMID: 32815907 DOI: 10.1097/rhu.0000000000001511] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Jaspreet Kaler
- From the Department of Rheumatology, University of Florida Health, Jacksonville, FL
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9
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Cutaneous drug-induced lupus erythematosus: Clinical and immunological characteristics and update on new associated drugs. Ann Dermatol Venereol 2021; 148:211-220. [PMID: 34711400 DOI: 10.1016/j.annder.2021.02.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 01/24/2021] [Accepted: 02/26/2021] [Indexed: 02/06/2023]
Abstract
Cutaneous drug-induced lupus erythematosus (CDILE) is a lupus-like syndrome related to drug exposure which typically resolves after drug discontinuation. It can present as a systemic or a sole cutaneous form and different drugs may be associated with each form. CDILE pharmacoepidemiology is constantly changing. Indeed, older drugs primarily associated with systemic CDILE are no longer prescribed and new drugs associated with either cutaneous or systemic CDILE have emerged. The present study discusses the clinical and laboratory aspects of CDILE and the postulated pathogenesis, and it provides an update on implicated drugs. We performed a literature review to single out the new drugs associated with CDILE in the past decade (January 2010-June 2020). Among 109 drugs reported to induce CDILE in 472 patients, we identified anti-TNFα, proton-pump inhibitors, antineoplastic drugs, and, in particular, checkpoint inhibitors, as emerging drugs in CDILE. Most of the published studies are cases reports or small case series, and further larger studies as well as the development of validated classification criteria are needed to better understand and characterize their implication in CDILE.
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10
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Worm M, Zidane M, Eisert L, Fischer-Betz R, Foeldvari I, Günther C, Iking-Konert C, Kreuter A, Müller-Ladner U, Nast A, Ochsendorf F, Schneider M, Sticherling M, Tenbrock K, Wenzel J, Kuhn A. S2k-Leitlinie zur Diagnostik und Therapie des kutanen Lupus erythematodes - Teil 2: Therapie, Risikofaktoren und spezielle Fragestellungen. J Dtsch Dermatol Ges 2021; 19:1371-1395. [PMID: 34541800 DOI: 10.1111/ddg.14491_g] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 02/20/2021] [Indexed: 01/03/2023]
Affiliation(s)
- Margitta Worm
- Allergologie und Immunologie, Klinik für Dermatologie, Venerologie und Allergologie, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin
| | - Miriam Zidane
- Division of Evidence-Based Medicine (dEBM), Klinik für Dermatologie, Venerologie und Allergologie, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin
| | - Lisa Eisert
- Klinik für Dermatologie und Venerologie, Vivantes Klinikum Neukölln, Berlin
| | - Rebecca Fischer-Betz
- Poliklinik und Funktionsbereich für Rheumatologie, Universitätsklinikum Düsseldorf, Düsseldorf
| | - Ivan Foeldvari
- Hamburger Zentrum für Kinder- und Jugendrheumatologie, Hamburg
| | - Claudia Günther
- Klinik und Poliklinik für Dermatologie, Universitätsklinikum Carl Gustav Carus, Dresden
| | - Christof Iking-Konert
- Zentrum für Innere Medizin der III. Medizinischen Klinik und Poliklinik, Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - Alexander Kreuter
- Dermatologie, Venerologie und Allergologie, Helios St. Elisabeth Klinik Oberhausen, Oberhausen
| | - Ulf Müller-Ladner
- Abteilung für Rheumatologie und Klinische Immunologie, Kerckhoff-Klinik GmbH, Bad Nauheim
| | - Alexander Nast
- Division of Evidence-Based Medicine (dEBM), Klinik für Dermatologie, Venerologie und Allergologie, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin
| | - Falk Ochsendorf
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Frankfurt, Frankfurt am Main
| | - Matthias Schneider
- Poliklinik und Funktionsbereich für Rheumatologie, Universitätsklinikum Düsseldorf, Düsseldorf
| | | | - Klaus Tenbrock
- Klinik für Kinder- und Jugendmedizin, Uniklinik RWTH Aachen, Aachen
| | - Jörg Wenzel
- Dermatologische Klinik, Universitätsklinikum Bonn, Bonn
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11
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Worm M, Zidane M, Eisert L, Fischer-Betz R, Foeldvari I, Günther C, Iking-Konert C, Kreuter A, Müller-Ladner U, Nast A, Ochsendorf F, Schneider M, Sticherling M, Tenbrock K, Wenzel J, Kuhn A. S2k guideline: Diagnosis and management of cutaneous lupus erythematosus - Part 2: Therapy, risk factors and other special topics. J Dtsch Dermatol Ges 2021; 19:1371-1395. [PMID: 34338428 DOI: 10.1111/ddg.14491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 02/20/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Margitta Worm
- Allergology and Immunology, Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health
| | - Miriam Zidane
- Division of Evidence-Based Medicine (dEBM), Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health
| | - Lisa Eisert
- Department of Dermatology and Venereology, Vivantes Klinikum Neukölln, Berlin
| | | | - Ivan Foeldvari
- Hamburg Center for Pediatric and Adolescent Rheumatology, Hamburg
| | - Claudia Günther
- Department and Clinic of Dermatology, University Hospital Carl Gustav Carus, Dresden
| | - Christof Iking-Konert
- Center for Internal Medicine at the IIIrd Medical Department and Clinic, University Hospital Hamburg-Eppendorf
| | - Alexander Kreuter
- Dermatology, Venereology and Allergology, Helios St. Elisabeth Klinik Oberhausen
| | - Ulf Müller-Ladner
- Department of Rheumatology and Clinical Immunology, Kerckhoff-Klinik GmbH, Bad Nauheim
| | - Alexander Nast
- Division of Evidence-Based Medicine (dEBM), Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health
| | - Falk Ochsendorf
- Department of Dermatology, Venereology and Allergology, University Hospital Frankfurt am Main
| | - Matthias Schneider
- Clinic and Functional Division for Rheumatology, University Hospital Düsseldorf
| | | | - Klaus Tenbrock
- Department of Pediatrics and Adolescent Medicine, University Hospital RWTH Aachen
| | - Jörg Wenzel
- Dermatological Department, University Hospital Bonn
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12
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Bostan E, Gulseren D, Yalici-Armagan B, Dogan S, Ates-Ozdemir D, Gokoz O, Kalyoncu U, Atakan N. Vasculitis during certolizumab pegol and secukinumab treatment: Report of two cases. Dermatol Ther 2021; 34:e15007. [PMID: 34046982 DOI: 10.1111/dth.15007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 05/24/2021] [Indexed: 12/17/2022]
Affiliation(s)
- Ecem Bostan
- Department of Dermatology and Venereology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Duygu Gulseren
- Department of Dermatology and Venereology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Basak Yalici-Armagan
- Department of Dermatology and Venereology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Sibel Dogan
- Department of Dermatology and Venereology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Deniz Ates-Ozdemir
- Department of Pathology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Ozay Gokoz
- Department of Pathology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Umut Kalyoncu
- Department of Rheumatology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Nilgün Atakan
- Department of Dermatology and Venereology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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13
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Ang E, Hadjieconomou S, Kalavala M. Brodalumab-induced subacute cutaneous lupus erythematosus. Clin Exp Dermatol 2021; 46:926-927. [PMID: 33511692 DOI: 10.1111/ced.14583] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 01/25/2021] [Accepted: 01/26/2021] [Indexed: 12/01/2022]
Affiliation(s)
- E Ang
- Department of Dermatology, University Hospital of Wales, Cardiff, UK
| | - S Hadjieconomou
- Department of Dermatology, University Hospital of Wales, Cardiff, UK
| | - M Kalavala
- Department of Dermatology, University Hospital of Wales, Cardiff, UK
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14
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Abstract
Cutaneous adverse drug reactions produce a significant clinical, financial, and psychological burden on our healthcare industry. The importance of considering a drug reaction in the cause of any dermatitis is underscored by the diversity of clinical manifestations and the prolific rate of drug discovery and approval. We present an update on the variety of drug reactions encountered in the inpatient and outpatient setting. Immunomodulatory drugs used in oncology will be reviewed separately as their clinical manifestations cross many reaction patters and morphologies.
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Affiliation(s)
- Robert T Spaulding
- Division of Dermatology, University of Louisville School of Medicine, Louisville, Kentucky, USA.
| | - Cindy E Owen
- Division of Dermatology, University of Louisville School of Medicine, Louisville, Kentucky, USA
| | - Jeffrey P Callen
- Division of Dermatology, University of Louisville School of Medicine, Louisville, Kentucky, USA
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15
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Tsai YC, Tsai TF. Switching biologics in psoriasis - practical guidance and evidence to support. Expert Rev Clin Pharmacol 2020; 13:493-503. [PMID: 32394765 DOI: 10.1080/17512433.2020.1767590] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Advances of biologic agents have changed the treatment paradigm of psoriasis to higher efficacy and better quality of life. However, the demand for biologic switch is increasing due to patient's greater expectation and decreasing efficacy in long-term use. Also, biologic-induced adverse effects necessitate the switching of biologics. AREAS COVERED This review article was divided into two parts. The first part focused on the biologic switch due to lack of efficacy. The second part provided switching suggestions related to adverse effects. EXPERT COMMENTARY Biologic switch in psoriasis was mainly due to lack of efficacy, and the subsequent biologic agent was usually given at the next scheduled time point without washout period. In pivotal randomized controlled trials, patients with poor response to TNF-alpha inhibitors and ustekinumab achieved better efficacy after switching to IL-23 and IL-17 inhibitors. In addition, real-world data showed that intra-class switch could still achieve a 50%-80% of PASI 75 response in individuals with anti-IL-17 failure histories. As for the biologic switch due to adverse effects, washout period was recommended and transition to a biologic agent with different modes of action was preferred, especially class-specific adverse events.
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Affiliation(s)
- Ya-Chu Tsai
- Department of Dermatology, Far Eastern Memorial Hospital , New Taipei, Taiwan
| | - Tsen-Fang Tsai
- Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine , Taipei, Taiwan
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16
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Petty AJ, Floyd L, Henderson C, Nicholas MW. Cutaneous Lupus Erythematosus: Progress and Challenges. Curr Allergy Asthma Rep 2020; 20:12. [PMID: 32248318 DOI: 10.1007/s11882-020-00906-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
PURPOSE OF REVIEW The review provides an update on the diagnosis, pathogenesis, and treatment of cutaneous lupus erythematosus (CLE). RECENT FINDINGS Diagnostic challenges exist in better defining CLE as an independent disease distinct from systemic lupus erythematosus with cutaneous features and further classifying CLE based on clinical, histological, and laboratory features. Recent mechanistic studies revealed more genetic variations, environmental triggers, and immunologic dysfunctions that are associated with CLE. Drug induction specifically has emerged as one of the most important triggers for CLE. Treatment options include topical agents and systemic therapies, including newer biologics such as belimumab, rituximab, ustekinumab, anifrolumab, and BIIB059 that have shown good clinical efficacy in trials. CLE is a group of complex and heterogenous diseases. Future studies are warranted to better define CLE within the spectrum of lupus erythematosus. Better insight into the pathogenesis of CLE could facilitate the design of more targeted therapies.
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Affiliation(s)
- Amy J Petty
- School of Medicine, Duke University, Durham, NC, 27710, USA
| | - Lauren Floyd
- Department of Dermatology, Duke University, Durham, NC, 27710, USA
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17
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Affiliation(s)
- Giannis Chatzimichail
- Comprehensive Center for Inflammation Medicine, University Hospital Schleswig-Holstein, Lübeck, Germany.,Department of Dermatology, Allergology and Venereology, University Hospital Schleswig-Holstein, Lübeck, Germany
| | - Detlef Zillikens
- Department of Dermatology, Allergology and Venereology, University Hospital Schleswig-Holstein, Lübeck, Germany
| | - Diamant Thaçi
- Comprehensive Center for Inflammation Medicine, University Hospital Schleswig-Holstein, Lübeck, Germany
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18
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Abstract
Introduction: There is a growing list of drugs implicated in inducing both subacute and chronic forms of cutaneous lupus erythematosus. It is important to recognize these drugs in order to quickly treat patients with drug induced disease.Areas covered: This paper reviews the current literature describing drugs implicated in causing cutaneous lupus erythematosus. A Pubmed search was used to compile a list of medications implicated up to August 2019. It reviews new classes of drugs identified as causing cutaneous lupus erythematosus, the pathophysiology of the disease process, and current recommendations for treatment of the disease.Expert opinion: Many drugs have been identified as inducing lupus, and many more continue to be described in new reports. Further research is needed to understand this phenomenon, which will aid in the diagnosis and treatment of affected patients.
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Affiliation(s)
- Robert Borucki
- Department of Dermatology, Corporal Michael J. Crescenz VAMC, Philadelphia, PA, USA.,Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Victoria P Werth
- Department of Dermatology, Corporal Michael J. Crescenz VAMC, Philadelphia, PA, USA.,Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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19
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Adverse Cutaneous Reactions of Common Biologic Medications for Rheumatic Diseases. CURRENT TREATMENT OPTIONS IN RHEUMATOLOGY 2019. [DOI: 10.1007/s40674-019-00129-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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20
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Lupus induits : les nouveautés. Ann Dermatol Venereol 2019; 146:340-342. [DOI: 10.1016/j.annder.2019.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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21
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Affiliation(s)
- Emma Tierney
- Dermatology Department, University Hospital Limerick, Limerick, Ireland
| | - Shivashini Kirthi
- Dermatology Department, University Hospital Limerick, Limerick, Ireland
| | - Bart Ramsay
- Dermatology Department, University Hospital Limerick, Limerick, Ireland
| | - Kashif Ahmad
- Dermatology Department, University Hospital Limerick, Limerick, Ireland
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22
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Dubash S, Bridgewood C, McGonagle D, Marzo-Ortega H. The advent of IL-17A blockade in ankylosing spondylitis: secukinumab, ixekizumab and beyond. Expert Rev Clin Immunol 2019; 15:123-134. [DOI: 10.1080/1744666x.2019.1561281] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Sayam Dubash
- NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
| | - Charlie Bridgewood
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
| | - Dennis McGonagle
- NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
| | - Helena Marzo-Ortega
- NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
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23
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Anthony E, Rajgopal Bala H, Goh MS, Balta S, Foley P. Ixekizumab-treatment-emergent photosensitive cutaneous eruption. Australas J Dermatol 2018; 59:e284-e286. [PMID: 29566260 DOI: 10.1111/ajd.12811] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Eleni Anthony
- Skin & Cancer Foundation Inc. Carlton, Victoria, Australia
| | - Harini Rajgopal Bala
- Skin & Cancer Foundation Inc. Carlton, Victoria, Australia.,Department of Dermatology, St Vincent's Hospital Melbourne, Fitzroy, Australia
| | - Michelle Sy Goh
- Skin & Cancer Foundation Inc. Carlton, Victoria, Australia.,Department of Dermatology, St Vincent's Hospital Melbourne, Fitzroy, Australia
| | - Showan Balta
- Department of Anatomical Pathology, St Vincent's Hospital Melbourne, Fitzroy, Australia
| | - Peter Foley
- Skin & Cancer Foundation Inc. Carlton, Victoria, Australia.,Department of Dermatology, St Vincent's Hospital Melbourne, Fitzroy, Australia.,University of Melbourne, Parkville, Victoria, Australia
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