Clinical approach to skin eruptions induced by anti-TNF agents among patients with inflammatory bowel diseases: insights from a multidisciplinary IBD-DERMA clinic

Background and Aims: Skin eruptions are prevalent among patients with inflammatory bowel diseases (IBD), often associated with therapies and frequently leading to dermatological consults and treatment interruptions. We aimed to assess the impact of joint shared decision-making in a multidisciplinary...

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Autores principales:	Henit Yanai, Hadar Amir Barak, Jacob E Ollech, Irit Avni Biron, Idan Goren, Yifat Snir, Hagar Banai Eran, Yelena Broitman, Maya Aharoni Golan, Elena Didkovsky, Iris Amitay-Laish, Ayelet Ollech, Emmilia Hodak, Iris Dotan, Lev Pavlovsky
Formato:	article
Lenguaje:	EN
Publicado:	SAGE Publishing 2021
Materias:	Diseases of the digestive system. Gastroenterology RC799-869
Acceso en línea:	https://doaj.org/article/88b32f4454734962ae309656aa9a48f8
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spelling	oai:doaj.org-article:88b32f4454734962ae309656aa9a48f82021-11-09T23:03:42ZClinical approach to skin eruptions induced by anti-TNF agents among patients with inflammatory bowel diseases: insights from a multidisciplinary IBD-DERMA clinic1756-284810.1177/17562848211053112https://doaj.org/article/88b32f4454734962ae309656aa9a48f82021-11-01T00:00:00Zhttps://doi.org/10.1177/17562848211053112https://doaj.org/toc/1756-2848Background and Aims: Skin eruptions are prevalent among patients with inflammatory bowel diseases (IBD), often associated with therapies and frequently leading to dermatological consults and treatment interruptions. We aimed to assess the impact of joint shared decision-making in a multidisciplinary (MDT) IBD-DERMA clinic. Methods: This retrospective cohort study assessed a consecutive group of patients with IBD who were referred for consultation in an MDT clinic at a tertiary referral center in Israel. Results: Over 1 year, 118 patients were evaluated in the MDT-IBD-DERMA clinic: 68 (57.6%) males; age – 35.2 ± 13.5 years, disease duration – 7.1 (interquartile range: 3.7–13.9) years; Crohn’s disease – 94/118 (79.6%). Skin eruption induced by an anti–tumor necrosis factor (TNF) were the most common diagnoses [46/118 (39%)], including psoriasiform dermatitis (PD) – 31/46 (67.4%) and inflammatory alopecia (IA) – 15/46 (32.6%). Of these, 18 patients (39.1%) continued the anti-TNF agent concomitantly with a topical or systemic anti-inflammatory agent to control the eruption. The remaining 28 patients (60.9%) discontinued the anti-TNF, of whom 16/28 (57.1%) switched to ustekinumab. These strategies effectively treated the majority [38/46 (82.6%)] of patients. Continuation of the anti-TNF was possible in a significantly higher proportion of patients with PD: 12/31 (38.7%) than only one in the IA group, p = 0.035. There was a higher switch to ustekinumab among the IA 7/15 (46.6%) compared with the PD 7/31 (22.6%) group, P = .09. Following IBD-DERMA advised intervention, IBD deteriorated in 9/4 6(19.5%) patients, 5/9 on ustekinumab (PD versus IA, P = NS). Conclusion: Shared decision-making in an integrated IBD-DERMA clinic allowed successful control of skin eruptions while preserving control of the underlying IBD in more than 80% of cases. Patients with IA profited from a switch to ustekinumab.Henit YanaiHadar Amir BarakJacob E OllechIrit Avni BironIdan GorenYifat SnirHagar Banai EranYelena BroitmanMaya Aharoni GolanElena DidkovskyIris Amitay-LaishAyelet OllechEmmilia HodakIris DotanLev PavlovskySAGE PublishingarticleDiseases of the digestive system. GastroenterologyRC799-869ENTherapeutic Advances in Gastroenterology, Vol 14 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Diseases of the digestive system. Gastroenterology RC799-869
spellingShingle	Diseases of the digestive system. Gastroenterology RC799-869 Henit Yanai Hadar Amir Barak Jacob E Ollech Irit Avni Biron Idan Goren Yifat Snir Hagar Banai Eran Yelena Broitman Maya Aharoni Golan Elena Didkovsky Iris Amitay-Laish Ayelet Ollech Emmilia Hodak Iris Dotan Lev Pavlovsky Clinical approach to skin eruptions induced by anti-TNF agents among patients with inflammatory bowel diseases: insights from a multidisciplinary IBD-DERMA clinic
description	Background and Aims: Skin eruptions are prevalent among patients with inflammatory bowel diseases (IBD), often associated with therapies and frequently leading to dermatological consults and treatment interruptions. We aimed to assess the impact of joint shared decision-making in a multidisciplinary (MDT) IBD-DERMA clinic. Methods: This retrospective cohort study assessed a consecutive group of patients with IBD who were referred for consultation in an MDT clinic at a tertiary referral center in Israel. Results: Over 1 year, 118 patients were evaluated in the MDT-IBD-DERMA clinic: 68 (57.6%) males; age – 35.2 ± 13.5 years, disease duration – 7.1 (interquartile range: 3.7–13.9) years; Crohn’s disease – 94/118 (79.6%). Skin eruption induced by an anti–tumor necrosis factor (TNF) were the most common diagnoses [46/118 (39%)], including psoriasiform dermatitis (PD) – 31/46 (67.4%) and inflammatory alopecia (IA) – 15/46 (32.6%). Of these, 18 patients (39.1%) continued the anti-TNF agent concomitantly with a topical or systemic anti-inflammatory agent to control the eruption. The remaining 28 patients (60.9%) discontinued the anti-TNF, of whom 16/28 (57.1%) switched to ustekinumab. These strategies effectively treated the majority [38/46 (82.6%)] of patients. Continuation of the anti-TNF was possible in a significantly higher proportion of patients with PD: 12/31 (38.7%) than only one in the IA group, p = 0.035. There was a higher switch to ustekinumab among the IA 7/15 (46.6%) compared with the PD 7/31 (22.6%) group, P = .09. Following IBD-DERMA advised intervention, IBD deteriorated in 9/4 6(19.5%) patients, 5/9 on ustekinumab (PD versus IA, P = NS). Conclusion: Shared decision-making in an integrated IBD-DERMA clinic allowed successful control of skin eruptions while preserving control of the underlying IBD in more than 80% of cases. Patients with IA profited from a switch to ustekinumab.
format	article
author	Henit Yanai Hadar Amir Barak Jacob E Ollech Irit Avni Biron Idan Goren Yifat Snir Hagar Banai Eran Yelena Broitman Maya Aharoni Golan Elena Didkovsky Iris Amitay-Laish Ayelet Ollech Emmilia Hodak Iris Dotan Lev Pavlovsky
author_facet	Henit Yanai Hadar Amir Barak Jacob E Ollech Irit Avni Biron Idan Goren Yifat Snir Hagar Banai Eran Yelena Broitman Maya Aharoni Golan Elena Didkovsky Iris Amitay-Laish Ayelet Ollech Emmilia Hodak Iris Dotan Lev Pavlovsky
author_sort	Henit Yanai
title	Clinical approach to skin eruptions induced by anti-TNF agents among patients with inflammatory bowel diseases: insights from a multidisciplinary IBD-DERMA clinic
title_short	Clinical approach to skin eruptions induced by anti-TNF agents among patients with inflammatory bowel diseases: insights from a multidisciplinary IBD-DERMA clinic
title_full	Clinical approach to skin eruptions induced by anti-TNF agents among patients with inflammatory bowel diseases: insights from a multidisciplinary IBD-DERMA clinic
title_fullStr	Clinical approach to skin eruptions induced by anti-TNF agents among patients with inflammatory bowel diseases: insights from a multidisciplinary IBD-DERMA clinic
title_full_unstemmed	Clinical approach to skin eruptions induced by anti-TNF agents among patients with inflammatory bowel diseases: insights from a multidisciplinary IBD-DERMA clinic
title_sort	clinical approach to skin eruptions induced by anti-tnf agents among patients with inflammatory bowel diseases: insights from a multidisciplinary ibd-derma clinic
publisher	SAGE Publishing
publishDate	2021
url	https://doaj.org/article/88b32f4454734962ae309656aa9a48f8
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Clinical approach to skin eruptions induced by anti-TNF agents among patients with inflammatory bowel diseases: insights from a multidisciplinary IBD-DERMA clinic

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