Disproportional increase in psoriasis reports in association with B cell depleting therapies in patients with multiple sclerosis. Mult Scler Relat Disord 2022 Jul;63:103832
Date
05/06/2022Pubmed ID
35512502DOI
10.1016/j.msard.2022.103832Scopus ID
2-s2.0-85129551192 (requires institutional sign-in at Scopus site)Abstract
BACKGROUND: Some pathways involved in the pathogenesis of psoriasis share similarities with processes involved in multiple sclerosis (MS) pathogenesis. However, the association between MS and psoriasis is poorly understood. Since disease-modifying therapies for MS have various targets, it may be possible that the occurrence of psoriasis varies by drug.
OBJECTIVE: To analyze the frequency of psoriasis reports in patients treated with various disease-modifying therapies for MS.
METHODS: Data was collected using the FDA Adverse Event Reporting System (FAERS) and OpenFDA database between January 2009 and June 2020. The study analyzed total reports of psoriasis out of total reports in the "Skin and Subcutaneous Tissue Disorders" category for each drug and explored age, sex distribution, and report source. OpenFDA data was used to perform statistical analyses including reporting odds ratios (ROR) and information components.
RESULTS: The study identified 517 psoriasis reports of 45,547 total skin and subcutaneous tissue disorders (1.13%) in FAERS. The highest proportions of reports in this study were associated with rituximab, ocrelizumab, and interferon beta 1a. The lowest proportion of reports were associated with glatiramer acetate, alemtuzumab, dimethyl fumarate and teriflunomide. Reports of other autoimmune skin disorders were minimal (29 vitiligo, 33 pemphigoid, and 7 pemphigus). Patients primarily drove reports for most DMTs versus healthcare providers. The proportion of reports from female patients were the highest for each DMT except alemtuzumab. OpenFDA query retrieved 302 total reports of psoriasis. Significantly increased reporting odds ratios (RORs, 95% confidence interval) of psoriasis were noted for rituximab (7.14, 3.92-13.00), ocrelizumab (3.79, 2.74-5.23), and fingolimod (1.33, 1.01-1.76). Significantly decreased RORs were noted for natalizumab (0.53, 0.36-0.80), glatiramer acetate (0.58, 0.35-0.96), and dimethyl fumarate (0.71, 0.53-0.94).
CONCLUSION: There are frequent reports of psoriasis in MS patients treated with various DMTs. However, reports and RORs were disproportionally high in association with B cell depleting therapies. Further research is required to determine if certain DMTs may serve as better options for individuals affected by, or at high-risk for developing psoriasis.
Author List
Porwal MH, Patel D, Maynard M, Obeidat AZAuthor
Ahmed Zayed Obeidat MD, PhD Associate Professor in the Neurology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AlemtuzumabDimethyl Fumarate
Female
Glatiramer Acetate
Humans
Immunosuppressive Agents
Multiple Sclerosis
Psoriasis
Rituximab
