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Skin reactions common in pediatric IBD patients treated with infliximab
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Pediatric patients with inflammatory bowel disease undergoing infliximab therapy experienced potentially harsh skin lesions, according to recent study data.
Researchers performed a prospective study of skin manifestations in 84 children (median age, 15.7 years) with IBD (76.1% Crohn’s disease) who received infliximab infusions from March 2011 to March 2013 at Children’s Hospital, Helsinki. Median therapy duration was 12.2 months, and most patients had no previous exposure to tumor necrosis factor-alpha agents. Blood inflammatory markers and fecal calprotectin levels also were measured at each infusion to evaluate disease activity.
Therapy-related skin reactions were observed in 47.6% of patients, with severe lesions occurring in 23.8%. Most lesions were psoriasis-like manifestations, and the most commonly affected areas were the ear lobes and scalp. Patients with ulcerative colitis had lower risk for treatment-related skin manifestations compared with patients who had Crohn’s disease (OR=0.25; 95% CI, 0.06-0.65). Patients with high fecal calprotectin levels also had a lower risk compared with patients whose levels were normal (OR=0.38; 95% CI, 0.14-0.79). The HLA-Cw*0602 allele linked to psoriasis was detected in 78% of the patients who experienced skin reactions.
“Skin lesions are frequently found in pediatric patients with IBD receiving TNF-a antagonist therapy,” the researchers concluded. “Although potentially harsh, skin lesions mostly allow continuation of infliximab. Intriguingly, the presentation of skin lesions seems to be related to a low level of intestinal inflammation, which warrants further studies on the pathophysiological mechanisms.”
Disclosure: The researchers report no relevant financial disclosures.
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