Newer Arthritis Drugs Linked to Skin Disorder

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<http://www.reuters.com/newsArticle.jhtml?type=healthNews & storyID=6603612>

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http://www.reuters.com/newsArticle.jhtml?type=healthNews & storyID=6603612

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> Newer Arthritis Drugs Linked to Skin Disorder

> Mon Oct 25, 2004 04:56 PM ET

>

> By

> NEW YORK (Reuters Health) - Newer drugs like Enbrel

> and Remicade have

> been a boon to many arthritis sufferers, but

> researchers now report

> that such drugs may lead to the development of an

> inflammatory

> disorder of blood vessels, usually affecting the

> skin.

>

> The drugs, called TNF blockers, have been linked to

> a condition called

> leukocytoclastic vasculitis, or LCV, according to an

> article in the

> Journal of Rheumatology. With LCV, bleeding of small

> blood vessels

> under the skin causes purplish raised areas to

> appear, usually on the

> legs.

>

> LCV has been described as a manifestation of

> rheumatoid arthritis

> itself, but the latest findings " suggests that it

> may occur as an

> adverse effect of anti-TNF therapy as well, " lead

> investigator Dr.

> Niveditha Mohan told Reuters Health.

>

> Mohan of the Avera Research Institute in Sioux

> Falls, South Dakota,

> and colleagues examined reports collected by the US

> Food and Drug

> Administration about adverse events associated with

> the use of TNF

> blockers.

>

> They identified 20 cases of LCV following Enbrel

> treatment and 15

> following Remicade use. While the drugs can be used

> to treat other

> conditions, rheumatoid arthritis was the most common

> among these

> cases. All but six of the patients were women.

>

> In total, 22 of the patients showed complete or

> marked improvement of

> their skin lesions when they stopped taking the

> agents.

>

> Three patients on Enbrel had continuing lesions

> despite

> discontinuation of the drug. One improved after

> switching to Remicade,

> but another subject on Remicade had continuing

> lesions despite

> discontinued treatment.

>

> Six patients had a recurrence of LCV when they

> re-started TNF blocker

> therapy, but " three patients did not have recurrence

> of their skin

> lesions following rechallenge with the same agents, "

> the researchers

> report.

>

> Given these findings, Mohan concluded that in such

> patients " along

> with investigating the usual causes of LCV,

> consideration should be

> given to stopping the anti-TNF agent to see if the

> symptoms improve. "

>

> In an accompanying editorial Drs. Loic Guillevin and

> Luc Mouthon of

> Hopital Cochin, Paris, note that there is a risk of

> side effects with

> any drugs. However, they stress that " these drugs

> are so beneficial

> that the risk of developing easily reversible

> vasculitis " should not

> generally discourage their use.

>

> SOURCE: Journal of Rheumatology, October 2004.

>

>

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