The skin tissue is adversely affected by TNF-alpha blockers in patients with chronic inflammatory arthritis: a 5-year prospective analysis

The skin tissue is adversely affected by TNF-alpha blockers in patients with chronic inflammatory arthritis: a 5-year prospective analysis

Author Machado, Natália Pereira Autor UNIFESP Google Scholar
Reis Neto, Edgard Torres dos Autor UNIFESP Google Scholar
Soares, Maria Roberta Melo Pereira Autor UNIFESP Google Scholar
Freitas, Daniele S. Google Scholar
Porro, Adriana Maria Autor UNIFESP Google Scholar
Ciconelli, Rozana Mesquita Autor UNIFESP Google Scholar
Pinheiro, Marcelo de Medeiros Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract OBJECTIVE: We evaluated the incidence of and the main risk factors associated with cutaneous adverse events in patients with chronic inflammatory arthritis following anti-TNF-α therapy. METHODS: A total of 257 patients with active arthritis who were taking TNF-α blockers, including 158 patients with rheumatoid arthritis, 87 with ankylosing spondylitis and 12 with psoriatic arthritis, were enrolled in a 5-year prospective analysis. Patients with overlapping or other rheumatic diseases were excluded. Anthropometric, socioeconomic, demographic and clinical data were evaluated, including the Disease Activity Score-28, Bath Ankylosing Spondylitis Disease Activity Index and Psoriasis Area Severity Index. Skin conditions were evaluated by two dermatology experts, and in doubtful cases, skin lesion biopsies were performed. Associations between adverse cutaneous events and clinical, demographic and epidemiological variables were determined using the chi-square test, and logistic regression analyses were performed to identify risk factors. The significance level was set at p<0.05. RESULTS: After 60 months of follow-up, 71 adverse events (73.85/1000 patient-years) were observed, of which allergic and immune-mediated phenomena were the most frequent events, followed by infectious conditions involving bacterial (47.1%), parasitic (23.5%), fungal (20.6%) and viral (8.8%) agents. CONCLUSION: The skin is significantly affected by adverse reactions resulting from the use of TNF-α blockers, and the main risk factors for cutaneous events were advanced age, female sex, a diagnosis of rheumatoid arthritis, disease activity and the use of infliximab.
Keywords TNF-alpha Blockers
Adverse Events
Rheumatoid Arthritis
Ankylosing Spondylitis
Language English
Sponsor Dermatology and Pathology departments
Date 2013-09-01
Published in Clinics. Faculdade de Medicina / USP, v. 68, n. 9, p. 1189-1196, 2013.
ISSN 1807-5932 (Sherpa/Romeo, impact factor)
1980-5322 (Sherpa/Romeo, impact factor)
Publisher Faculdade de Medicina / USP
Extent 1189-1196
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000326016600003
SciELO ID S1807-59322013000901189 (statistics in SciELO)

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