Aliki I Venetsanopoulou, Konstantina Mavridou, Eleftherios Pelechas, Paraskevi V Voulgari, Alexandros A Drosos
{"title":"使用 ADA 生物仿制药治疗后出现斑秃:病例报告。","authors":"Aliki I Venetsanopoulou, Konstantina Mavridou, Eleftherios Pelechas, Paraskevi V Voulgari, Alexandros A Drosos","doi":"10.2174/0115733971266803231117072453","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Tumor necrosis factor alpha (TNFα) is a pivotal cytokine involved in the pathogenesis of certain inflammatory diseases, such as rheumatoid arthritis (RA), spondyloarthropathies, and inflammatory bowel diseases. In the last two decades, TNFα inhibitors (TNFi) have revolutionized the treatment and outcome of the above disorders. However, the use of TNFi has been associated with the development of many autoimmune phenomena and paradoxical skin manifestations that may present as the same type of clinical indications for which the TNFi effectively used. Thus, they may display as arthritis, uveitis, colitis, psoriasis, and several other cutaneous clinical manifestations, among them the development of morphea, a localized scleroderma skin lesion.</p><p><strong>Case presentation: </strong>We describe a 58-year-old woman with seronegative RA, refractory to methotrexate, who was treated with ABP-501 (Hefiya), an adalimumab (ADA) biosimilar and developed an oval-shaped, deep skin lesion of approximately 3.5cm in size, affecting the left part of her back compatible with morphea 3 months after the initiation of therapy. ADA biosimilar was discontinued and two months later, she had substantial skin improvement.</p><p><strong>Conclusion: </strong>This is the first report of morphea manifestation during TNFi biosimilar since the patient had no other trigger factors for morphea development like trauma and infections. Physicians dealing with patients treated with TNFi biosimilars should be aware of paradoxical skin reactions, among them morphea; thus, close monitoring, a minute and careful clinical examination, and a follow- up check are required.</p>","PeriodicalId":11188,"journal":{"name":"Current rheumatology reviews","volume":" ","pages":"451-454"},"PeriodicalIF":1.2000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Development of Morphea Following Treatment with an ADA Biosimilar: A Case Report.\",\"authors\":\"Aliki I Venetsanopoulou, Konstantina Mavridou, Eleftherios Pelechas, Paraskevi V Voulgari, Alexandros A Drosos\",\"doi\":\"10.2174/0115733971266803231117072453\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Tumor necrosis factor alpha (TNFα) is a pivotal cytokine involved in the pathogenesis of certain inflammatory diseases, such as rheumatoid arthritis (RA), spondyloarthropathies, and inflammatory bowel diseases. In the last two decades, TNFα inhibitors (TNFi) have revolutionized the treatment and outcome of the above disorders. However, the use of TNFi has been associated with the development of many autoimmune phenomena and paradoxical skin manifestations that may present as the same type of clinical indications for which the TNFi effectively used. Thus, they may display as arthritis, uveitis, colitis, psoriasis, and several other cutaneous clinical manifestations, among them the development of morphea, a localized scleroderma skin lesion.</p><p><strong>Case presentation: </strong>We describe a 58-year-old woman with seronegative RA, refractory to methotrexate, who was treated with ABP-501 (Hefiya), an adalimumab (ADA) biosimilar and developed an oval-shaped, deep skin lesion of approximately 3.5cm in size, affecting the left part of her back compatible with morphea 3 months after the initiation of therapy. ADA biosimilar was discontinued and two months later, she had substantial skin improvement.</p><p><strong>Conclusion: </strong>This is the first report of morphea manifestation during TNFi biosimilar since the patient had no other trigger factors for morphea development like trauma and infections. Physicians dealing with patients treated with TNFi biosimilars should be aware of paradoxical skin reactions, among them morphea; thus, close monitoring, a minute and careful clinical examination, and a follow- up check are required.</p>\",\"PeriodicalId\":11188,\"journal\":{\"name\":\"Current rheumatology reviews\",\"volume\":\" \",\"pages\":\"451-454\"},\"PeriodicalIF\":1.2000,\"publicationDate\":\"2024-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Current rheumatology reviews\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.2174/0115733971266803231117072453\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"RHEUMATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Current rheumatology reviews","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2174/0115733971266803231117072453","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"RHEUMATOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景:肿瘤坏死因子α(TNFα)是一种关键的细胞因子,参与了某些炎症性疾病的发病机制,如类风湿性关节炎(RA)、脊柱关节病和炎症性肠病。在过去二十年中,TNFα抑制剂(TNFi)彻底改变了上述疾病的治疗和疗效。然而,TNFi的使用也与许多自身免疫现象和矛盾性皮肤表现的出现有关,这些现象和表现可能与TNFi的有效临床适应症类型相同。因此,它们可能表现为关节炎、葡萄膜炎、结肠炎、银屑病和其他一些皮肤临床表现,其中包括发生局部硬皮病皮损--斑秃:我们描述了一名患有血清阴性 RA 且对甲氨蝶呤难治的 58 岁女性患者,她接受了阿达木单抗(ADA)生物类似物 ABP-501 (海飞亚) 的治疗,在开始治疗 3 个月后,她的背部左侧出现了一个约 3.5 厘米大小的椭圆形深层皮损,与莫皮瘤相吻合。停用 ADA 生物类似物两个月后,她的皮肤状况得到了很大改善:这是首例在使用 TNFi 生物类似物期间出现斑秃的报告,因为患者没有其他诱发斑秃的因素,如外伤和感染。医生在接诊使用 TNFi 生物仿制药治疗的患者时,应警惕矛盾性皮肤反应,其中包括斑秃;因此,需要进行密切监测、细致入微的临床检查和随访检查。
Development of Morphea Following Treatment with an ADA Biosimilar: A Case Report.
Background: Tumor necrosis factor alpha (TNFα) is a pivotal cytokine involved in the pathogenesis of certain inflammatory diseases, such as rheumatoid arthritis (RA), spondyloarthropathies, and inflammatory bowel diseases. In the last two decades, TNFα inhibitors (TNFi) have revolutionized the treatment and outcome of the above disorders. However, the use of TNFi has been associated with the development of many autoimmune phenomena and paradoxical skin manifestations that may present as the same type of clinical indications for which the TNFi effectively used. Thus, they may display as arthritis, uveitis, colitis, psoriasis, and several other cutaneous clinical manifestations, among them the development of morphea, a localized scleroderma skin lesion.
Case presentation: We describe a 58-year-old woman with seronegative RA, refractory to methotrexate, who was treated with ABP-501 (Hefiya), an adalimumab (ADA) biosimilar and developed an oval-shaped, deep skin lesion of approximately 3.5cm in size, affecting the left part of her back compatible with morphea 3 months after the initiation of therapy. ADA biosimilar was discontinued and two months later, she had substantial skin improvement.
Conclusion: This is the first report of morphea manifestation during TNFi biosimilar since the patient had no other trigger factors for morphea development like trauma and infections. Physicians dealing with patients treated with TNFi biosimilars should be aware of paradoxical skin reactions, among them morphea; thus, close monitoring, a minute and careful clinical examination, and a follow- up check are required.
期刊介绍:
Current Rheumatology Reviews publishes frontier reviews on all the latest advances on rheumatology and its related areas e.g. pharmacology, pathogenesis, epidemiology, clinical care, and therapy. The journal"s aim is to publish the highest quality review articles dedicated to clinical research in the field. The journal is essential reading for all researchers and clinicians in rheumatology.