医学
英夫利昔单抗
依那西普
银屑病
银屑病性关节炎
贾纳斯激酶
类风湿性关节炎
皮肤病科
肿瘤坏死因子α
免疫学
妥珠单抗
内科学
细胞因子
阿达木单抗
作者
Michael J. Woodbury,Carly Grant,Lourdes M. Pérez-Chada,Avery LaChance,Joseph F. Merola
出处
期刊:Journal of Drugs in Dermatology
[SanovaWorks]
日期:2024-01-01
卷期号:23 (2): e60-e63
被引量:3
摘要
Tumor necrosis factor-alpha inhibitors (TNF-i) are commonly used to treat immune-mediated diseases such as psoriasis, psoriatic arthritis (PsA), inflammatory bowel disease (IBD), spondyloarthritis (SpA) and rheumatoid arthritis (RA). However, paradoxical psoriasis induced by TNF-i has been described and is not uncommon, particularly with infliximab and etanercept. The presentation of TNF-i-induced psoriasis is most commonly plaque or palmoplantar morphology. Optimal treatment strategies for recalcitrant psoriatic disease are not well understood. In this case series, we report three patients with TNF-i-induced psoriasis who were treated with upadacitinib and experienced complete resolution of their psoriatic eruptions. The efficacy of Janus kinase inhibitors (JAK-i) is possibly explained by mechanisms involving uncontrolled production of type 1 IFNs as well as increases in IL-23 and T-helper 17 cells upstream of relevant JAK/STAT pathways. We also offer a proposed treatment algorithm that includes the use of JAK-i as a promising management option in patients with recalcitrant disease. However, larger studies are needed to confirm the efficacy and safety of JAK-i in this patient population.
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