Acne improves with TNF inhibitors, but treatment may also incite condition
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Key takeaways:
- Tumor necrosis factor-alpha inhibitors incited partial (53.2%) and complete clearance (40.4%) in patients with acne.
- The inhibitors caused acne development in 63.8% of patients.
While tumor necrosis factor-alpha inhibitors have shown positive results in the treatment of acne, the use of these inhibitors for other conditions may incite new acne development, according to a study.
In this study, researchers characterized the demographics, clinical presentations, treatments and outcomes of patients receiving tumor necrosis factor-alpha (TNF) inhibitors to treat acne and those who developed acne after TNFi treatment for other conditions.
“TNF inhibitors can be a useful treatment for severe and recalcitrant acne or acne in the setting of autoinflammatory syndromes such as SAPHO (synovitis, acne, pustulosis, hyperostosis, osteitis), PAPA (pyogenic arthritis, pyoderma gangrenosum, and acne), and PASH (pyoderma gangrenosum, acne, and hidradenitis suppurativa),” John S. Barbieri, MD, MBA, assistant professor at Harvard Medical School and director of the advanced acne therapeutics clinic at Brigham and Women’s Hospital and assistant professor at Harvard Medical School, told Healio.
Using PubMed and Web of Science databases from inception to Oct. 17, 2022, Barbieri and colleagues conducted a systematic literature review that included 53 studies comprised of 64 patients. Adalimumab (n = 7), infliximab (n = 9) and etanercept (n = 1) were the included TNF inhibitors.
Results showed that of the 47 patients with acne treated with TNF inhibitors, 25 (53.2%) saw partial improvement and 19 (40.4%) achieved complete clearance.
On the other hand, researchers also found that TNF inhibitors may occasionally be associated with the development of acne, especially in those with no prior history of the condition. Acne manifested in 30 patients (63.8%) as part of an inflammatory response. Of the 17 patients who experienced acne after TNF inhibitor treatment for conditions other than acne, only one patient reported a history of acne.
According to Barbieri, these cases of acne were severe enough that patients either discontinued TNF inhibitor treatment (n = 8) or altered their treatment (n = 6).
“The fact that TNF inhibitors can act as both a treatment and cause of acne also provides insight into the importance of TNF and [interleukin]-17 signaling in the pathogenesis of acne,” Barbieri said.
Only three patients reported adverse effects, according to the study.
Based on these results, the authors concluded that TNF inhibitors are a potential treatment for severe and recalcitrant acne; however, if acne develops after treatment, it may be due to the TNF inhibitor.
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