Andrade P, et al. - The incidence, risk factors, management, and outcome of anti-tumor necrosis factor (TNF)-induced dermatological complications were evaluated in a large cohort of inflammatory bowel disease (IBD) patients. Researchers found dermatological manifestations in almost 1/3^rd of the study population. The most common complications included infection, however, anti-TNF-induced psoriasiform lesions were the most common cause for anti-TNF therapy definitive discontinuation.

Methods

• Researchers performed this observational retrospective study at a single tertiary referral center.
• They identified all consecutive adult IBD patients treated with anti-TNF agents between 2005 and 2015.
• They included patients who developed at least 1 dermatological complication while on anti-TNF therapy.

Results

• A total of 211 patients (29%) developed at least 1 dermatological complication among the 732 patients who were treated with anti-TNF agents: 52% women (mean age of 42 ± 13 years), 85% with Crohn’s disease, 67% were under infliximab.
• Under anti-TNF therapy, median follow-up time was 53 (27-77) months.
• Infections (13.5%), psoriasiform lesions (5.3%), injection/infusion reactions (3.8%), skin cancer (0.5%), and miscellaneous (5.6%) were the recorded dermatological complications.
• In multivariable analysis, independent risk factors for dermatological complications were female gender (OR = 1.658, p=0.029), smoking (OR = 2.021, p=0.003), and treatment with an infliximab dose of 10 mg/kg (OR = 2.012, p=0.007).
• Factors independently associated with development of psoriasiform lesions were female gender (OR = 3.63, p=0.017), smoking (OR = 2.846, p=0.041), and treatment with adalimumab (OR = 8.894, p < 0.001).
• Definitive, anti-TNF therapy discontinuation was noted in 3 (3%) patients with infectious complications and 12 (31%) patients with psoriasiform lesions.