P395 Dermatological reactions associated with anti–TNF therapy in inflammatory bowel disease- an 12 year experience
Notice bibliographique
Résumé
Anti-TNF therapies have significantly influenced our treatment paradigms and are amongst our most effective therapies to induce and maintain remission. They are, however, not without side effects. Data on dermatological complications are limited. Our aim was to describe the incidence, management and outcome of dermatological complications of anti-TNF therapy in IBD patients at our centre. We conducted a retrospective review of 435 consecutive IBD patients treated with anti-TNF (Infliximab or Adalimumab) therapy between 2005 and 2017. Data were collected from electronic case records and included demographics, disease characteristics, medical history, treatment and dermatological complications. Forty-four patients (10.1%) had dermatological complications. Of these, 25 were female (56.8%). Thirty-four patients had Crohn’s disease (CD = 77.2%) and 10 had ulcerative colitis (UC = 22.8%). Disease phenotype in CD was A2(24) L3(22) B1(21) in respective categories whereas 7/10 UC patients had Montreal E3 disease. Mean age at diagnosis was 34.31 years (median 28, IQR 23.5). Thirty-four patients were treated with Infliximab. The most common reaction reported was a non-specific rash in 11 patients, eczema in 8, and psoriasiform reactions in 7 patients. Shingles was noted in 5 cases and 3 patients had urticaria. Seborrheic dermatitis, cellulitis, itching, acne, and skin abscesses were noted in two patients each along with one case each of Lichen planus and chicken pox. The average time of onset of symptoms from initiation of treatment was 20 months(median 7, IQR 27). Twenty of 34 patients treated with infliximab, continued treatment following the dermatological side effect without any further reactions,12 were switched to adalimumab of which 1 patient had a further psoriasiform reaction leading to cessation of Anti TNF therapy and initiation of ustekinumab. One patient was not given any further Anti-TNF treatment after the initial reaction and one patient was switched to ustekinumab after the reaction. Of 10 patients on adalimumab who had dermatological side effects, all continued on therapy without any further reactions. The incidence of dermatological effects was 10.1% in our cohort. We did not observe a “class effect” as after switching to a different anti TNF the tolerability was good. Dermatological events were more common in patients with colonic CD treated with infliximab. Further studies on cumulative dermatological effects, risk factors, time to event and outcomes are underway at our institution.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».