The predictors of paradoxical reactions, especially psoriasis, to biologic therapy-findings from the TReasure database: a 5-year follow-up study

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dc.authoridErden, Abdulsamet/0000-0002-8084-2018
dc.authoridGonullu, Emel/0000-0002-6990-4206
dc.authoridcinaklı, haluk/0000-0003-1757-0598
dc.authoridKanıtez, Nilüfer Alpay/0000-0003-1185-5816
dc.authoridmercan, ridvan/0000-0003-1537-2192
dc.authoridyılmaz, recep/0000-0001-8806-8621
dc.authoridBilgin, Emre/0000-0002-2260-4660
dc.authorwosidErden, Abdulsamet/W-2397-2019
dc.authorwosidGonullu, Emel/AAK-7851-2021
dc.authorwosidcinaklı, haluk/JAX-2633-2023
dc.authorwosidKanıtez, Nilüfer Alpay/W-7332-2019
dc.authorwosidmercan, ridvan/W-3342-2017
dc.authorwosidYağız, Burcu/JQW-5031-2023
dc.authorwosidpehlivan, yavuz/AAG-8227-2021
dc.contributor.authorYagiz, Burcu
dc.contributor.authorLermi, Nihal
dc.contributor.authorCoskun, Belkis N.
dc.contributor.authorDalkilic, Ediz
dc.contributor.authorKiraz, Sedat
dc.contributor.authorErden, Abdulsamet
dc.contributor.authorErtenli, Ihsan
dc.date.accessioned2024-06-12T10:54:37Z
dc.date.available2024-06-12T10:54:37Z
dc.date.issued2023
dc.departmentTrakya Üniversitesien_US
dc.description.abstractObjectives The objectives of this study were to assess the clinical characteristics, predictive factors, and practical algorithms of paradoxical reactions (PRs), specifically paradoxical psoriasis (PP). Methods The TReasure database is a web-based prospective observational cohort comprised of patients with RA and SpA from 17 centres around Turkey since 2017. A cohort study and a case-control study nestled within the cohort were identified. Results In total, 2867 RA and 5316 SpA patients were evaluated. The first biologic agent was found to have caused PRs in 60% of the 136 patients (1.66%) who developed the PRs. The median time interval between the PRs and biological onset was 12 months (range 1-132 months, mean 21 months). The most common types of PP, constituting 92.6% of PRs, were pustular (60.3%) and palmoplantar (30.9%). Adalimumab (30.9%), infliximab (19%) and etanercept (17.4%) were the most common agents causing the PP. In the treatment of most PP patients (73.2%), switching biologic agents was favoured, with TNF inhibitor (TNFi) chosen in 46.03% and non-TNFi in 26.9% of cases. The three most frequently selected drugs were etanercept (24.6%), secukinumab (9.5%) and adalimumab (8.7%). Only 5.17% of patients who switched to another TNFi showed progression. The odds ratios (s) for SSZ, HCQ, and LEF use were significantly higher in RA controls than in PP patients (P = 0.033, OR = 0.15; P = 0.012, OR = 0.15; and P = 0.015, OR = 0.13, respectively). In the PP group with SpA, the number of smokers was significantly higher (P = 0.003, OR: 2.0, 95% CI: 1.05, 3.81). Conclusion Contrary to expectations based on earlier research suggesting that paradoxical reactions develop with the class effect of biological agents, the response of patients who were shifted to another TNFi was favourable.en_US
dc.description.sponsorshipHacettepe Rheumatology Association (HRD); Hacettepe Financial Enterprisesen_US
dc.description.sponsorshipFunding for this study was provided by the Hacettepe Rheumatology Association (HRD) and Hacettepe Financial Enterprises.en_US
dc.identifier.doi10.1093/rheumatology/kead318
dc.identifier.endpage3967en_US
dc.identifier.issn1462-0324
dc.identifier.issn1462-0332
dc.identifier.issue12en_US
dc.identifier.pmid37354493en_US
dc.identifier.scopus2-s2.0-85178649377en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.startpage3962en_US
dc.identifier.urihttps://doi.org/10.1093/rheumatology/kead318
dc.identifier.urihttps://hdl.handle.net/20.500.14551/19115
dc.identifier.volume62en_US
dc.identifier.wosWOS:001025987200001en_US
dc.identifier.wosqualityN/Aen_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherOxford Univ Pressen_US
dc.relation.ispartofRheumatologyen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectBiologic Agentsen_US
dc.subjectParadoxical Reactionsen_US
dc.subjectPsoriasisen_US
dc.subjectPredictorsen_US
dc.subjectTNF-Alpha Inhibitorsen_US
dc.subjectInflammatory-Bowel-Diseaseen_US
dc.subjectInhibitor-Induced Psoriasisen_US
dc.subjectClinical-Featuresen_US
dc.subjectLesionsen_US
dc.titleThe predictors of paradoxical reactions, especially psoriasis, to biologic therapy-findings from the TReasure database: a 5-year follow-up studyen_US
dc.typeArticleen_US

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