Anti-TNFs linked to new onset psoriasis in pediatric IBD
LAS VEGAS — New-onset psoriasis occurred more frequently in children with inflammatory bowel disease who received anti-TNF biologic therapy than it did in their counterparts who did not receive biologics, according to a presenter at the Crohn’s & Colitis Congress.
“New autoimmune disorders were noted approximately once every 100 patient years in the anti-TNF biologics cohort and were significantly more common compared to the nonbiologics cohort,” Richard Colletti, MD, of the University of Vermont Children’s Hospital in Burlington, Vermont, said during his presentation. “New autoimmune disorders do arise in anti-TNF biologics-treated pediatric IBD patients but overall are uncommon and not serious.”
Colletti presented data from the DEVELOP Experience. The data presented went through June 30, 2018, and the registry included 21,0831 patient years (PY) of follow-up in the anti-TNF biologics cohort and 11,277 PY in the nonbiologics cohort.
The physicians participating in the DEVELOP Experience recorded all new autoimmune disorders seen on semi-annual visits, defining “serious autoimmune disorders” as those requiring hospitalization, threatening life or resulting in permanent damage.
Coletti showed that there was approximately one new autoimmune disorder per 100 patient years for the anti-TNF group. New-onset psoriasis was the most frequently reported new-onset autoimmune disorder in this cohort (0.58 events per 100 PY; n = 123). The nonbiologics cohort had two cases of psoriasis (0.02 events per 100 PY), he said.
Serious new autoimmune disorders were less common in both groups (0.2 events per PY in the anti-TNF group and 0.07 events per 100 PY in the nonbiologics group). These serious disorders included lupus-like syndrome, sclerosing cholangitis, autoimmune hepatitis, optic neuritis, Nemoch-Schonlein purpura and Takayasu’s arteritis.
Colletti noted that the analysis did not take disease severity into account between the two groups.
“Greater disease severity may predispose to a higher incidence of disease-related complications,” he said. “Some patients may have received higher doses of biologics because of more intense disease activity.” – by Katrina Altersitz
Colletti R. Abstract 2. Presented at: Crohn’s & Colitis Congress; Feb. 7-9, 2019; Las Vegas.
Disclosures: Colletti reports acting as a consultant for and on advisory committees for AbbVie and Janssen Biotech.