抗 TNF-α 诱导的强直性脊柱炎患者的矛盾性银屑病：系统评价。
Anti-TNF-α induced paradoxical psoriasis in patients with ankylosing spondylitis: a systematic review.
机构信息
Rheumazentrum Ruhrgebiet-Ruhr-University Bochum, Herne, Germany.
Department of Rheumatology, Patras University Hospital, University of Patras Medical School, Patras, Greece.
出版信息
Clin Exp Rheumatol. 2024 Jan;42(1):178-184. doi: 10.55563/clinexprheumatol/rq4k3u. Epub 2023 Oct 5.
OBJECTIVES
The approval of TNF-a inhibitors (TNFi) was a breakthrough in the treatment of ankylosing spondylitis (AS). Although also effective in psoriasis, drug-related adverse events of onset of psoriasiform skin lesions - paradoxical psoriasis (PP) under TNFi have been reported.
METHODS
We performed an electronic data search in MEDLINE via Pubmed and Cochrane library scientific databases from inception to January 2023, following the PRISMA guidelines. We assessed the distinct characteristics and frequency of risks for PP appearance in AS patients treated with different TNFi.
RESULTS
PP was found in 0.5-1% of TNFi-treated AS patients and the latency period was 2-11 months. The safest TNFi in terms of PP induction was certolizumab, whereas the one most commonly associated with PP was infliximab.
CONCLUSIONS
PP is an uncommon adverse reaction to TNFi treatment in AS patients and responds well to drug withdrawal. More large data studies need to be conducted though, to shed light on PP nature and management.
目的
TNF-α 抑制剂（TNFi）的获批是治疗强直性脊柱炎（AS）的一个突破。尽管在银屑病中也有效，但在 TNFi 治疗下，药物相关的不良反应，即出现银屑病样皮损——矛盾性银屑病（PP），已有报道。
方法
我们按照 PRISMA 指南，在 MEDLINE 上通过 Pubmed 和 Cochrane 图书馆科学数据库进行了电子数据检索，检索时间从建库至 2023 年 1 月。我们评估了不同 TNFi 治疗的 AS 患者出现 PP 表现的独特特征和风险频率。
结果
PP 在接受 TNFi 治疗的 AS 患者中的发生率为 0.5-1%，潜伏期为 2-11 个月。在诱导 PP 方面最安全的 TNFi 是 certolizumab，而最常与 PP 相关的是 infliximab。
结论
PP 是 AS 患者接受 TNFi 治疗的一种罕见不良反应，停药后反应良好。然而，需要进行更多的大型数据研究，以阐明 PP 的性质和管理。
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