Open AccessInfliximab Paradoxical Psoriasis in a Cohort of Children With Inflammatory Bowel Disease
Author(s) -
Courbette Olivier,
Aupiais Camille,
Viala Jerome,
Hugot JeanPierre,
Louveau Baptiste,
Chatenoud Lucienne,
Bourrat Emmanuelle,
MartinezVinson Christine
Publication year - 2019
Publication title -
journal of pediatric gastroenterology and nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.206
H-Index - 131
eISSN - 1536-4801
pISSN - 0277-2116
DOI - 10.1097/mpg.0000000000002349
Subject(s) - medicine , psoriasis , infliximab , interquartile range , inflammatory bowel disease , ulcerative colitis , crohn's disease , retrospective cohort study , gastroenterology , cohort , adalimumab , dermatology , disease , surgery
Objectives: In adult inflammatory bowel disease (IBD) treated by anti‐TNF antibodies, paradoxical psoriasis has an estimated prevalence of 1.6 to 22%, especially in infliximab (IFX)‐treated patients. Little is known in the pediatric IBD (PIBD) populations. Methods: All patients ages from 2 to 18 years with Crohn disease (CD) or ulcerative colitis (UC) and treated for the first time by IFX between January 2002 and March 2014, were considered for inclusion in this retrospective study performed in a tertiary PIBD centre. Paradoxical psoriasis events together with clinical and biological data were collected in all patients. Comparisons between psoriasis and control groups were performed using univariate statistical analyses. Results: One hundred and twenty‐three CD patients and 24 UC patients were treated with IFX. Twenty patients (13.6%) experienced a paradoxical psoriasis. All of them were affected by CD. Perianal CD was more frequent in the psoriasis group ( P = 0.033). Fourteen patients (70%) were in remission when skin lesions occurred. Paradoxical psoriasis was diagnosed 355 days (median, interquartile range [IQR] 239; 532) after the initiation of IFX corresponding to the eighth injection (median, IQR: 6; 15). Psoriasis lesions were controlled by local steroids in all cases and no patients discontinued IFX therapy. Conclusions: 13.6% of our IBD patients treated with IFX developed psoriasis during a median follow‐up of 23.9 months (IQR: 11.6; 36.5). Crohn disease patients with perianal disease were at a higher risk to develop this common side effect.