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Anti-TNF-a, new biologics show promise for patients with psoriasis, lupus erythematosus
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Anti-tumor necrosis factor-alpha agents and newer biologics, such as ustekinumab and abatacept, were found to be promising treatments for patients with coexistent psoriasis and lupus erythematosus, according to study results.
Suzanne J. Tintle, MD, MPH, and colleagues conducted a retrospective study of 96 patients diagnosed with psoriasis or psoriatic arthritis (PsA) and lupus erythematosus (LE; systemic LE or cutaneous LE, including either subacute cutaneous LE or discoid LE) from two tertiary care academic institutions in Boston. The risk of lupus flares with anti-tumor necrosis factor-alpha (TNF-a) agents also was investigated.
The researchers found higher-than-expected rates of white race (77.1%) and PsA among the patients studied.
Additionally, a 42% prevalence of PsA was observed among patients with cutaneous psoriasis, which was considered relatively high compared with the lower rates typically seen in the general cutaneous psoriasis-alone population (11% to 39%), according to the researchers.
Twenty-five patients received treatment with TNF-a inhibitors, ustekinumab or abatacept at an average of 6.7 years after final diagnosis of psoriasis/PsA and SLE/CLE. The researchers observed reports of improvement for both cutaneous psoriasis and cutaneous SLE symptoms, as well as improvements in lupus arthritis, ulceration of the mouth and hematologic abnormalities.
Clinical lupus flares in patients with LE treated with TNF-a inhibitors were infrequent, according to the researchers. Only one patient receiving a TNF-a inhibitor experienced a clinical lupus flare, which resulted in a 0.92% incidence of lupus flares per patient-year of TNF-a inhibitor use. The flare was resolved once the agent was discontinued and the patient received treatment with cyclophosphamide.
Disclosure: The authors have no relevant financial disclosures.
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