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The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis
11:39

The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis

Published on: July 11, 2013

Infectious complications in patients with psoriasis and rheumatoid arthritis treated with antitumor necrosis factor

Kamruz Darabi1, Rohit Jaiswal, Sarah Hostetler

  • 1Division of Dermatology, The Ohio State University, Columbus, OH, USA.

Journal of Drugs in Dermatology : JDD
|February 14, 2009
PubMed

Insights

Patients on biologic therapies like etanercept and methotrexate for psoriasis may face rare serious infections. However, studies suggest these treatments, including antitumor necrosis factor (anti-TNF) agents, do not significantly increase infection risk.

Area of Science:

  • Immunology
  • Dermatology
  • Rheumatology

Background:

  • Moderate-to-severe psoriasis and psoriatic arthritis treatments involve systemic therapies, including biologics, antimetabolites, and immunosuppressants.
  • Careful consideration of adverse events, particularly serious infectious complications, is crucial before and during treatment.

Observation:

  • A case report details a male patient with a long history of psoriasis and psoriatic arthritis on combination etanercept and methotrexate therapy.
  • This patient developed a spontaneous epidural abscess, leading to quadriplegia.

Findings:

  • A literature review examined the risk of serious infections associated with antitumor necrosis factor (anti-TNF) monotherapy or combination therapy with methotrexate.
  • Current evidence suggests that etanercept and other anti-TNF agents, alone or with methotrexate, do not appear to elevate the risk of serious infections.

Implications:

  • While the overall risk may not be increased, clinicians must carefully assess the benefits and risks of anti-TNF therapy in infection-prone patients.
  • Vigilance for serious infectious complications remains essential during immunosuppressive therapy for autoimmune conditions.

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