TNF-alpha blockers interfere with the function of the immune system, the researchers believe this may be the mechanism by which the skin problems develop. The researchers followed 289 control group and 289 test group patients who had rheumatoid arthritis for an average of 2.3 years. 72 of the patients in the group that took TNF-alpha drugs developed skin problems, but only 37 control group patients.
Treatment of rheumatoid arthritis with the potent TNF-alpha blocking drugs -- such as Enbrel and Remicade, for example -- is linked to an increase in dermatological conditions, researchers in the Netherlands suggest.
Dr. Marcel Flendrie and colleagues, based at Radboud University Nijmegen Medical Center, studied 289 patients with rheumatoid arthritis who were starting treatment with Remicade (known generically as infliximab), Humira (adalimumab), Enbrel (etanercept) or an experimental drug lenercept -- all TNF-alpha blockers.
The individuals in the study were matched with 289 "control" subjects with rheumatoid arthritis who had never been given TNF-alpha blocking therapy.
During an average follow-up of 2.3 years, skin problems occurred in 72 treated patients but in only 37 control patients, the team reports in the medical journal Arthritis Research and Therapy.
The skin conditions included infections and eczema, both of which might logically be related to the way TNF blockers work, by interfering with the immune system.
The investigators also documented drug-related skin ulcers and malignant tumors, as well as a list of less common problems.
They say more studies are need to look into these skin disorders "because they are a clinically significant problem in rheumatoid arthritis patients receiving TNF-alpha-blocking therapy," Flendrie's group concludes.