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Development of MGUS in psoriatic patients: a possible undiagnosed event during anti-TNF-α-treatment

F Prignano1, L Pescitelli, F Ricceri

  • 1Department of Dermatological Sciences, Florence University, Santa Maria Annunziata Hospital, Florence, Italy. francesca.prignano@unifi.it

Journal of the European Academy of Dermatology and Venereology : JEADV
|August 13, 2011
PubMed
Abstract

Insights

Treatment with anti-tumor necrosis factor-alpha (anti-TNF-α) therapies may be linked to the development of monoclonal gammopathy of undetermined significance (MGUS) in patients with psoriasis and psoriatic arthritis. Further research is needed to confirm this association.

Area of Science:

  • Hematology
  • Immunology
  • Dermatology

Background:

  • Monoclonal gammopathies (MGs) involve plasma cell proliferation producing monoclonal immunoglobulins.
  • MGs have been reported with various drugs, but not previously with anti-tumor necrosis factor-alpha (anti-TNF-α) therapies like adalimumab, etanercept, and infliximab.
  • These anti-TNF-α treatments are used for moderate-to-severe psoriasis and psoriatic arthritis.

Purpose of the Study:

  • To describe the occurrence of monoclonal gammopathy of undetermined significance (MGUS) in patients with psoriasis undergoing anti-TNF-α treatment.
  • To investigate a potential association between anti-TNF-α therapy and MGUS development.

Main Methods:

  • A case series involving 300 patients with chronic plaque psoriasis or psoriatic arthritis treated with anti-TNF-α in Italy.
  • Patients were screened for MGUS using serum protein electrophoresis.

Main Results:

  • Eight patients developed monoclonal gammopathy of undetermined significance (MGUS).
  • The median treatment duration was 1 year.
  • Specific immunoglobulin patterns observed included excess IgG (5 patients), excess IgM (1 patient), and double monoclonal components (2 patients).

Conclusions:

  • The findings suggest a potential association between anti-TNF-α therapy and the development of MGUS.
  • Further investigation is warranted to elucidate this relationship.

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