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A well-recognized but rare complication of tumor necrosis factor (TNF)-α antagonist therapy is the development of psoriasis. Most patients who experience this complication have inflammatory bowel disease (IBD) or rheumatoid arthritis, but some with existing psoriasis experience a change in their disease. Among the questions regarding management of patients who develop this complication, the most pressing are whether the TNF antagonist can be continued or whether another agent would be better tolerated.
These authors focused on 150 patients with IBD who developed psoriasis while on TNF antagonist therapy — 30 from their medical center and an additional 120 from the literature. Seventy percent were women; 85% had Crohn disease. Most were on in…