Related Experiment Video

Updated: Jan 5, 2026

Expression of Exogenous Cytokine in Patient-derived Xenografts via Injection with a Cytokine-transduced Stromal Cell Line
12:58

Expression of Exogenous Cytokine in Patient-derived Xenografts via Injection with a Cytokine-transduced Stromal Cell Line

Published on: May 10, 2017

9.8K

Psoriasis Associated With Tumor Necrosis Factor Inhibitors in Children With Inflammatory Diseases

Lisa H Buckley1, Rui Xiao2, Marissa J Perman3

  • 1Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, and Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tennessee.

Arthritis Care & Research
|October 25, 2019
PubMed

Insights

Children with inflammatory bowel disease (IBD), juvenile idiopathic arthritis (JIA), and chronic noninfectious osteomyelitis (CNO) have a higher incidence of psoriasis, especially when treated with tumor necrosis factor inhibitors (TNFi). This study quantifies this increased risk.

Area of Science:

  • Pediatric Rheumatology
  • Dermatology
  • Gastroenterology

Background:

  • Psoriasis incidence is elevated in pediatric patients with IBD, JIA, and CNO.
  • The role of tumor necrosis factor inhibitors (TNFi) in the development of psoriasis in these pediatric populations requires further investigation.

Purpose of the Study:

  • To estimate the incidence rate (IR) of psoriasis in children with IBD, JIA, and CNO.
  • To compare psoriasis incidence between children exposed to TNFi and those not exposed.
  • To compare psoriasis incidence in these pediatric cohorts to the general pediatric population.

Main Methods:

  • Retrospective cohort study of 4,111 children diagnosed with IBD, JIA, or CNO between 2008 and 2018.
  • TNFi exposure defined by prescription of specific biologic agents (adalimumab, etanercept, infliximab, certolizumab, golimumab).
  • Incident psoriasis was the primary outcome, with IRs, standardized incidence ratios (SIRs), and Cox proportional hazards models used for analysis.

Main Results:

  • Children with TNFi exposure had a significantly higher incidence of psoriasis (12.3 per 1,000 person-years) compared to those without TNFi exposure (3.8 per 1,000 person-years).
  • The standardized incidence ratio (SIR) for psoriasis was 18 overall, with higher rates in the TNFi-exposed group (SIR 30) versus the unexposed group (SIR 9.3).
  • TNFi exposure was associated with a 3.84-fold increased hazard of developing psoriasis (95% CI 2.28-6.47; P < 0.001).

Conclusions:

  • Pediatric patients with IBD, JIA, and CNO exhibit an increased incidence of psoriasis compared to the general pediatric population.
  • TNFi therapy in these pediatric cohorts is associated with a substantially higher risk of developing psoriasis.
  • Further research is warranted to understand the mechanisms and management strategies for psoriasis in pediatric patients on TNFi therapy.
Abstract

More Related Videos

The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis11:39

The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis

Published on: July 11, 2013

39.4K
Author Spotlight: Exploring the Role of Inflammation in the Co-occurrence of Primary Sjogren's Syndrome and Lung Adenocarcinoma10:21

Author Spotlight: Exploring the Role of Inflammation in the Co-occurrence of Primary Sjogren's Syndrome and Lung Adenocarcinoma

Published on: September 20, 2024

702

Related Concept Videos

Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF01:24

Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF

Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab...
424
T Cell Types and Functions01:24

T Cell Types and Functions

When T cells with CD4 markers are activated, they give rise to two types of effector cells: helper T cells and regulatory T cells. Meanwhile, T cells with CD8 markers differentiate into effector cytotoxic T cells. The differentiation of CD4 T cells into helper T cell subsets, such as Th1, Th2, and Th17 cells, is dependent on the antigen type, antigen-presenting cell, and regulatory cytokines.
Th1 cells stimulate dendritic cells to express necessary co-stimulatory molecules on their surfaces for...
2.1K
Skin Diseases and Disorders01:23

Skin Diseases and Disorders

Skin is the first line of defense and encounters a variety of microbes. Some pathogenic strains are often the cause of a broad range of infections of the skin and other body systems. These conditions can affect people of all ages and may have different causes, including genetic factors, infections, autoimmune reactions, environmental factors, and lifestyle choices.
Gram-positive Staphylococcus spp. and Streptococcus spp. are responsible for many of the most common skin infections. However, many...
5.1K
Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents01:29

Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents

Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
443
Inflammatory Bowel Disease II: Crohn's Disease01:30

Inflammatory Bowel Disease II: Crohn's Disease

Introduction
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
898
Tumor Immunotherapy01:27

Tumor Immunotherapy

Immunotherapy is a treatment that boosts or manipulates the immune system to fight diseases, including cancer. For instance, by stimulating an immune response through vaccinations against viruses that cause cancers, like hepatitis B virus and human papillomavirus, these diseases can be prevented. Nonetheless, some cancer cells can avoid the immune system due to their rapid mutation and division. The immune response to many cancers involves three phases: elimination, equilibrium, and escape.
1.7K