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Ustekinumab Improves Outcomes in Children With Anti-TNF Induced Skin Reactions
Switching to ustekinumab may offer improved outcomes for children who develop skin reactions from anti-tumor necrosis factor (anti-TNF) therapy for inflammatory bowel disease, according to study findings published online ahead of print in the Journal of Crohn’s and Colitis.
“Anti-TNF induced skin reactions are common adverse events in pediatric inflammatory bowel disease,” wrote researchers from the Icahn School of Medicine at Mount Sinai in the study background. “We aimed to report on outcomes of children with anti-TNF induced skin reactions who switched to ustekinumab vs continued anti-TNF therapy.”
Investigators reviewed charts for 638 patients with pediatric inflammatory bowel disease, 111 (17%) of whom developed skin reactions to anti-TNF therapy. Among them, 80 had psoriasiform dermatitis, 25 had infectious skin reactions, and 4 had alopecia areata.
Just over a third of patients with skin reactions switched to ustekinumab, while 64% continued on anti-TNF therapy, researchers reported. Patients who switched to ustekinumab were more likely to have anti-TNF induced skin reactions that were severe.
At 6 months, switching to ustekinumab was associated with a 73% rate of resolution and a 52% rate of combined remission, according to the study. Continuing anti-TNF therapy was associated with a 34% rate of resolution and 31% rate of combined remission.
Odds ratios were 19.7 for resolution and 8.5 for combined remission with a ustekinumab switch compared with anti-TNF therapy continuation.
“Children who switched to ustekinumab after anti-TNF induced skin reactions were more likely to have improved outcomes than those who continued anti-TNF therapy,” researchers wrote. “Future studies are needed to determine immune mechanisms of anti-TNF induced skin reactions and treatment response.”
—Jolynn Tumolo
Reference:
Dolinger MT, Rolfes P, Spencer E, Stoffels G, Dunkin D, Dubinsky MC. Outcomes of children with inflammatory bowel disease who develop anti-tumor necrosis factor induced skin reactions. J Crohns Colitis. Published online ahead of print April 7, 2022. https://doi.org/10.1093/ecco-jcc/jjac055
