Psoriasis induced or aggravated by tumor necrosis factor-alpha antagonists in the treatment of autoimmune diseases:a meta-analysis
SHAN Fangfang
YAN Zhihua
MAO Pan
CHEN Lingling
Abstract：Objective To investigate the clinical features,treatment and prognosis of psoriasis induced or aggravated by tumor nrctosis factor-alpha(TNF-α)antagonists in the treatment of autoimmune diseases.Methods Medline,Springerlink,Sciencedirect,Wiley,Web of Science,CNKI,Wanfang and CBM database were retrospectively searched for the clinical data on patients with psoriasis induced or aggravated by TNF-α antagonist therapy,as reported in both domestic and international literature.These data were then subjected to a meta-analysis.Results A total of 27 articles were incorporated into tihs study,including 78 patients(33 cases with rheumatoid arthritis,18 with Crohn's disease,9 with psoriatic arthritis,9 with ankylosing spondylitis,2 with ABD,2 with juvenile idiopathic arthritis,1 with seronegative spondyloarthropathy,1 with ulcerative colitis,1 with seronegative spondyloarthropathy and Crohn's disease,1 with Behcet's disease,and 1 with SAPHO syndrome).Their clinical features including:(1)Higher prevalence in women,particularly among middle-aged and older individuals.(2)Psoriatic can be induced by commonly used TNF-α antagonists,such as etanercept,infliximab,and adalimumab.(3)The occurrence of adverse reactions ranged from a minimum of 4 days to a maximum of 72 months.However,most patients developed psoriatic within the first year of treatment.(4)The main type of newly induced psoriasis was pustular psoriasis,with palmoplantar pustulosis being the most common,followed by vulgar psoriasis.(5)The psoriasis induced by TNF-α antagonists can be effectively managed with topical corticosteroids in most patients.However,a small proportion of severe cases may necessitate systemic treatment.Additionally,some patients may need to switch or discontinue TNF-α antagonist therapy.(6)The clinical features of most patients with skin lesions aligned with histopathological findings.(7)A small number of patients had a personal or family history of psoriasis.(8)A small number of patients havd a history of smoking.Conclusion TNF-α antagonists can induce or aggravate psoriasis in patients with autoimmune diseases.In clinical practice,potential adverse reactions should be closely monitored,and the best treatment strategy should be selected based on the specific situation of the patient.
Keywords：PsoriasisTNF-alpha antagonistsAdalimumabEtanerceptInfliximabDermatological reactions
Publication Date：2024-12-10
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 337-340,344 )