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Tumor necrosis factor inhibitor-associated dermatomyositis
Rachel Klein1, Misha Rosenbach, Ellen J Kim
1Department of Medicine, Division of Rheumatology, University of Pennsylvania School of Medicine, Perelman Center for Advanced Medicine, First Floor South Pavilion, 3400 Civic Center Blvd., Philadelphia, PA 19104, USA.
Archives of Dermatology
|July 21, 2010
Summary
Tumor necrosis factor (TNF) inhibitors, like etanercept and adalimumab, rarely trigger or worsen dermatomyositis. This autoimmune condition involves skin and muscle inflammation, and these cases highlight a potential link to TNF inhibitor therapy.
Area of Science:
- Rheumatology
- Dermatology
- Immunology
Background:
- Dermatomyositis is an autoimmune disorder causing skin and muscle inflammation.
- The exact cause of dermatomyositis is unknown.
- Tumor necrosis factor (TNF) inhibitors are rarely linked to dermatomyositis onset.
Observation:
- Four patients with inflammatory arthritis were treated with TNF inhibitors (etanercept, adalimumab) for 2 months to 2 years.
- All patients developed dermatomyositis symptoms, including rash and muscle weakness.
- Symptoms persisted after stopping TNF inhibitors but improved with corticosteroids and immunosuppressants.
Findings:
- The reported cases suggest TNF inhibitors can induce or exacerbate dermatomyositis.
- This association is rare compared to other autoimmune disorders like vasculitis or lupus-like syndrome.
- Dermatomyositis onset or worsening occurred after exposure to etanercept and adalimumab.
Implications:
- Clinicians should consider dermatomyositis in patients using TNF inhibitors who develop characteristic symptoms.
- Further research is needed to understand the mechanism linking TNF inhibitors to dermatomyositis.
- This finding expands the known spectrum of autoimmune side effects associated with TNF inhibitor therapy.
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