Focus on skin cancer association and progression under TNF antagonist therapy.
PIERARD-FRANCHIMONT, Claudine ; PIERARD, Gérald ; QUATRESOOZ, Pascale
in Expert Opinion on Biological Therapy (2011), 11(9), 1215-22
INTRODUCTION: Basal and squamous cell carcinomas are the most common non-melanoma skin cancers (NMSC) in humans. Their prevalence is higher in immunocompromized patients. Results of some animal ... [more ▼]
INTRODUCTION: Basal and squamous cell carcinomas are the most common non-melanoma skin cancers (NMSC) in humans. Their prevalence is higher in immunocompromized patients. Results of some animal experiments have indicated that TNF acts both as a tumour promotor and an inductor of apoptosis. AREAS COVERED: Peer-reviewed articles about human skin cancers possibly related to TNF antagonists. The occurrence and growth kinetics of NMSC are possibly increased in some patients under TNF antagonist therapy. Other issues of such biological treatment suggested include the activation of other distinct skin malignancies, including malignant melanoma. Benign melanocytic tumours appear to be boosted as well. At present, most of the reported findings only represent anecdotal case reports. The influence of cumulative co-factors must not be neglected, particularly the effect of other therapies administered to the patients. The occurrence of antibodies to some TNF antagonists may decrease both the treatment efficacy and the risk of skin cancer progression. EXPERT OPINION: More research needs to be performed in order to firmly establish and understand the risk of anti-TNF biologicals in the area of human skin cancers. At present, NMSC progression appears to be boosted on areas of skin field cancerization. Benign melanocytic naevi may develop as well. [less ▲]Detailed reference viewed: 43 (2 ULg)
The therapeutic potential of TNF-alpha antagonists for skin psoriasis comorbidities.
Pierard, Gérald ; Pierard, Claudine ; Szepetiuk, Grégory et al
in Expert Opinion on Biological Therapy (2010), 10(8), 1197-208
IMPORTANCE OF THE FIELD: Alopecia, psoriatic arthritis, the metabolic syndrome, inflammatory bowel diseases and cardiovascular diseases may occur as skin psoriatic comorbidities. TNF-alpha antagonists are ... [more ▼]
IMPORTANCE OF THE FIELD: Alopecia, psoriatic arthritis, the metabolic syndrome, inflammatory bowel diseases and cardiovascular diseases may occur as skin psoriatic comorbidities. TNF-alpha antagonists are used to treat psoriasis. Adalimumab is one of the recognized active agents for this indication. AREAS COVERED IN THIS REVIEW: The current peer-reviewed publications and presentation of original findings. WHAT THE READER WILL GAIN: Adalimumab is active on recalcitrant psoriasis and some of its comorbidities, particularly arthropathies and Crohn's disease. However, the progression of the radiological alterations is limited with regression of the bony erosions. Psoriatic enthesopathy also regresses. Mortality associated with psoriasis arthropathy is on the decline. Crohn's disease, the most frequent inflammatory bowel comorbidity of psoriasis, is responsive to adalimumab. The effect of adalimumab on the metabolic syndrome and cardiovascular involvement is more erratic. The spectacular effects of adalimumab may be associated with some adverse effects. In particular, despite a marked reduction in the psoriasis area-and-severity index (PASI) score some new acute lesions of cutaneous psoriasis may develop corresponding to paradoxical psoriasis. Other potential adverse effects include infections, granulomas, rapid growth of cancers and occurrence of lymphomas. TAKE HOME MESSAGE: Adalimumab frequently controls moderate-to-severe forms of cutaneous psoriasis and some of its comorbidities. [less ▲]Detailed reference viewed: 37 (4 ULg)