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news.Following the recent controversy over the COX-2s class of drugs, the second most important family of drugs used to treat rheumatoid arthritis, TNF-alpha blocking agents, has now been linked to serious dermatological conditions in a quarter of patients.
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A recent study, which was published in the journal Arthritis Research and Therapy, shows that TNF-alpha blocking agents trigger skin conditions in 25% of patients undergoing treatment. TNF-alpha blocking agents are used to halt the process of joint destruction in patients with severe arthritis conditions.
In the first study of its kind, researchers from Radboud University Nijmegen Medical Centre in the Netherlands followed a population of 289 patients who had been undergoing treatment for rheumatoid arthritis with TNF-alpha blocking drugs for a period of one to ten years.
The drugs the patients had been taking included two anti-TNF-alpha antibodies, infliximab (Centocor and Schering-Plough’s Remicade) and adalimumab (Abbott’s Humira), and the TNF-alpha receptors etanercept (Wyeth and Amgen’s Enbrel) and lenercept.
The results of the study show that 25% of patients on therapy suffered from a dermatological condition that led them to visit a skin specialist. In a control group of patients who were not undergoing TNF-alpha blocking therapy, and had less severe disease, only 13% visited a dermatologist during the same period of time.
The most frequent conditions that patients on therapy suffered from were skin infections. In addition, 12 patients were diagnosed with skin tumor and nine with an ulcer. In total, 26% of the patients who developed a dermatological condition ceased their treatment due to the condition.
Dermatological conditions such as skin infections are common in rheumatoid arthritis patients, but the use of TNF-alpha blocking therapy might increase susceptibility, as TNF-alpha is a major player in the immune response to infections. Down-regulating TNF-alpha might also trigger another type of immune response, which increases susceptibility to eczema, a condition not usually associated with rheumatoid arthritis.
More prospective studies need to be carried out to investigate the incidence of skin disease in patients on therapy, but this study reveals clinically significant adverse effects of TNF-alpha blocking therapy.