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

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dc.contributor.authorMachado, Natália Pereira [UNIFESP]
dc.contributor.authorReis Neto, Edgard Torres dos [UNIFESP]
dc.contributor.authorSoares, Maria Roberta Melo Pereira [UNIFESP]
dc.contributor.authorFreitas, Daniele S.
dc.contributor.authorPorro, Adriana Maria [UNIFESP]
dc.contributor.authorCiconelli, Rozana Mesquita [UNIFESP]
dc.contributor.authorPinheiro, Marcelo de Medeiros [UNIFESP]
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.date.accessioned2015-06-14T13:45:37Z
dc.date.available2015-06-14T13:45:37Z
dc.date.issued2013-09-01
dc.description.abstractOBJECTIVE: 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.en
dc.description.affiliationUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Rheumatology Division
dc.description.affiliationUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Dermatology Department, Psoriasis Clinic
dc.description.affiliationUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Center for Health Economics
dc.description.affiliationUnifespUNIFESP, EPM, Rheumatology Division
dc.description.affiliationUnifespUNIFESP, EPM, Dermatology Department, Psoriasis Clinic
dc.description.affiliationUnifespUNIFESP, EPM, Center for Health Economics
dc.description.sourceSciELO
dc.description.sponsorshipDermatology and Pathology departments
dc.format.extent1189-1196
dc.identifierhttp://dx.doi.org/10.6061/clinics/2013(09)03
dc.identifier.citationClinics. Faculdade de Medicina / USP, v. 68, n. 9, p. 1189-1196, 2013.
dc.identifier.doi10.6061/clinics/2013(09)03
dc.identifier.fileS1807-59322013000901189.pdf
dc.identifier.issn1807-5932
dc.identifier.issn1980-5322
dc.identifier.scieloS1807-59322013000901189
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/7939
dc.identifier.wosWOS:000326016600003
dc.language.isoeng
dc.publisherFaculdade de Medicina / USP
dc.relation.ispartofClinics
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectTNF-alpha Blockersen
dc.subjectSkinen
dc.subjectAdverse Eventsen
dc.subjectRheumatoid Arthritisen
dc.subjectAnkylosing Spondylitisen
dc.titleThe skin tissue is adversely affected by TNF-alpha blockers in patients with chronic inflammatory arthritis: a 5-year prospective analysisen
dc.typeinfo:eu-repo/semantics/article
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