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1. Diagnostic delay in patients with inflammatory bowel disease in Austria

Author

Novacek, Gottfried, Gröchenig, Hans Peter, Haas, Thomas, Wenzl, Heimo, Steiner, Pius, Koch, Robert, Feichtenschlager, Thomas, Eckhardt, Gerald, Mayer, Andreas, Kirchgatterer, Andreas, Ludwiczek, Othmar, Platzer, Reingard, Papay, Pavol, Gartner, Johanna, Fuchssteiner, Harry, Miehsler, Wolfgang, Peters, Paul-Gerhard, Reicht, Gerhard, Vogelsang, Harald, Dejaco, Clemens, Waldhör, Thomas, and Austrian IBD Study Group (ATISG)

Published
2019
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2. Prevalence and indicators of use of complementary and alternative medicine in Austrian patients with inflammatory bowel disease

Author

Gröchenig, Hans Peter, Waldhör, Thomas, Haas, Thomas, Wenzl, Heimo, Steiner, Pius, Koch, Robert, Feichtenschlager, Thomas, Eckhardt, Gerald, Mayer, Andreas, Kirchgatterer, Andreas, Ludwiczek, Othmar, Platzer, Reingard, Papay, Pavol, Gartner, Johanna, Fuchssteiner, Harry, Miehsler, Wolfgang, Peters, Paul-Gerhard, Reicht, Gerhard, Kutschera, Maximilian, Dejaco, Clemens, Vogelsang, Harald, and Novacek, Gottfried

Published
2019
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5. Clinical presentation of venous thromboembolism in inflammatory bowel disease

Author

Papay, Pavol, Miehsler, Wolfgang, Tilg, Herbert, Petritsch, Wolfgang, Reinisch, Walter, Mayer, Andreas, Haas, Thomas, Kaser, Arthur, Feichtenschlager, Thomas, Fuchssteiner, Harry, Knoflach, Peter, Vogelsang, Harald, Platzer, Reingard, Tillinger, Wolfgang, Jaritz, Bernhard, Schmid, Alfons, Blaha, Benedikt, Dejaco, Clemens, Sobala, Anna, Weltermann, Ansgar, Eichinger, Sabine, and Novacek, Gottfried

Published
2013
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9. The First European Evidence-based Consensus on Extra-intestinal Manifestations in Inflammatory Bowel Disease

Author

Harbord, Marcus, Annese, Vito, Vavricka, Stephan R., Allez, Matthieu, Barreiro-de Acosta, Manuel, Boberg, Kirsten Muri, Burisch, Johan, De Vos, Martine, De Vries, Anne-Marie, Dick, Andrew D., Juillerat, Pascal, Karlsen, Tom H., Koutroubakis, Ioannis, Lakatos, Peter L., Orchard, Tim, Papay, Pavol, Raine, Tim, Reinshagen, Max, Thaci, Diamant, Tilg, Herbert, and Carbonnel, Franck

Published
2016
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11. Anti-TNF antibody-induced psoriasiform skin lesions in patients with inflammatory bowel disease are characterised by interferon-γ-expressing Th1 cells and IL-17A/IL-22-expressing Th17 cells and respond to anti-IL-12/IL-23 antibody treatment

Author

Tillack, Cornelia, Ehmann, Laura Maximiliane, Friedrich, Matthias, Laubender, Rüdiger P, Papay, Pavol, Vogelsang, Harald, Stallhofer, Johannes, Beigel, Florian, Bedynek, Andrea, Wetzke, Martin, Maier, Harald, Koburger, Maria, Wagner, Johanna, Glas, Jürgen, Diegelmann, Julia, Koglin, Sarah, Dombrowski, Yvonne, Schauber, Jürgen, Wollenberg, Andreas, and Brand, Stephan

Published
2014
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13. H1N1 vaccines in a large observational cohort of patients with inflammatory bowel disease treated with immunomodulators and biological therapy

Author

Rahier, Jean-François, Papay, Pavol, Salleron, Julia, Sebastian, Shaji, Marzo, Manuela, Peyrin-Biroulet, Laurent, Garcia-Sanchez, Valle, Fries, Walter, van Asseldonk, Dirk P, Farkas, Klaudia, de Boer, Nanne K, Sipponen, Taina, Ellul, Pierre, Louis, Edouard, Peake, Simon T C, Kopylov, Uri, Maul, Jochen, Makhoul, Badira, Fiorino, Gionata, Yazdanpanah, Yazdan, and Chaparro, Maria

Published
2011
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15. sj-pdf-1-ueg-10.1177_2050640620946874 - Supplemental material for Use of complementary and alternative medicine and low quality of life associate with the need for psychological and psychotherapeutic interventions in inflammatory bowel disease

Author

Kutschera, Maximilian, Waldhör, Thomas, Gröchenig, Hans Peter, Haas, Thomas, Wenzl, Heimo, Steiner, Pius, Koch, Robert, Feichtenschlager, Thomas, Eckhardt, Gerald, Mayer, Andreas, Kirchgatterer, Andreas, Ludwiczek, Othmar, Platzer, Reingard, Papay, Pavol, Gartner, Johanna, Fuchssteiner, Harry, Paul-Gerhard Peters, Reicht, Gerhard, Moser, Gabriele, Dejaco, Clemens, Vogelsang, Harald, Primas, Christian, Novacek, Gottfried, and Miehsler, Wolfgang

Subjects
FOS: Clinical medicine, FOS: Biological sciences, 111199 Nutrition and Dietetics not elsewhere classified, FOS: Health sciences, 110308 Geriatrics and Gerontology, 69999 Biological Sciences not elsewhere classified, 111299 Oncology and Carcinogenesis not elsewhere classified
Abstract

Supplemental material, sj-pdf-1-ueg-10.1177_2050640620946874 for Use of complementary and alternative medicine and low quality of life associate with the need for psychological and psychotherapeutic interventions in inflammatory bowel disease by Maximilian Kutschera, Thomas Waldhör, Hans Peter Gröchenig, Thomas Haas, Heimo Wenzl, Pius Steiner, Robert Koch, Thomas Feichtenschlager, Gerald Eckhardt, Andreas Mayer, Andreas Kirchgatterer, Othmar Ludwiczek, Reingard Platzer, Pavol Papay, Johanna Gartner, Harry Fuchssteiner, Paul-Gerhard Peters, Gerhard Reicht, Gabriele Moser, Clemens Dejaco, Harald Vogelsang, Christian Primas, Gottfried Novacek and Wolfgang Miehsler in United European Gastroenterology Journal

Published
2020
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18. Use of complementary and alternative medicine and low quality of life associate with the need for psychological and psychotherapeutic interventions in inflammatory bowel disease

Author

Kutschera, Maximilian, Waldhör, Thomas, Gröchenig, Hans Peter, Haas, Thomas, Wenzl, Heimo, Steiner, Pius, Koch, Robert, Feichtenschlager, Thomas, Eckhardt, Gerald, Mayer, Andreas, Kirchgatterer, Andreas, Ludwiczek, Othmar, Platzer, Reingard, Papay, Pavol, Gartner, Johanna, Fuchssteiner, Harry, Peters, Paul‐Gerhard, Reicht, Gerhard, Moser, Gabriele, Dejaco, Clemens, Vogelsang, Harald, Primas, Christian, Novacek, Gottfried, and Miehsler, Wolfgang

Abstract

Patients with inflammatory bowel disease (IBD) suffer from various symptoms, impairing their quality of life and often affecting psychosocial issues. This may lead to the need for additional psychological care. This study investigated patients' subjective need for integrated psychosomatic support and psychotherapy and indicators for it. This is a cross‐sectional multicentre study in Austrian IBD patients who were in routine care at 18 IBD outpatient clinics. Patients filled in an anonymous, validated questionnaire (Assessment of the Demand for Additional Psychological Treatment Questionnaire [ADAPT]) assessing the need for psychological care. The ADAPT gives two separate scores: the need for integrated psychosomatic support and for psychotherapy. In addition, health‐related quality of life and the use of complementary and alternative medicine as well as clinical and socio‐demographic variables were queried. Multivariable regression analysis was performed to estimate the effect of the previously mentioned variables on the need for additional psychological care. Of 1286 patients, 29.7% expressed a need for additional psychological care, 19.6% expressed a need for integrated psychosomatic support and 20.2% expressed a need for psychotherapy. In the multivariable analysis, the two strongest indicators for the need for both types of psychological care were the use of complementary and alternative medicine (for integrated psychosomatic support: odds ratio = 1.64, 95% confidence interval 1.13–2.39, p= 0.010; for psychotherapy: odds ratio = 1.74, 95% confidence interval 1.20–2.53, p= 0.004), and a low health‐related quality of life score (for integrated psychosomatic support: odds ratio = 0.95, 95% confidence interval 0.94–0.96, p< 0.001; for psychotherapy: odds ratio = 0.96, 95% confidence interval 0.94–0.97, p< 0.001). About 30% of the Austrian IBD patients expressed a need for integrated psychosomatic support and/or psychotherapy. The most important indicators for this need were the use of complementary and alternative medicine and low quality of life. What is already known? Despite ongoing improvement of treatment options, patients may not respond to treatment or may develop side effects. Due to this burden of disease, patients may also suffer from psychological symptoms, such as depressionIn our previous study in 2008, we found that 31% of patients with inflammatory bowel disease (IBD) expressed a subjective need for psychological interventions Despite ongoing improvement of treatment options, patients may not respond to treatment or may develop side effects. Due to this burden of disease, patients may also suffer from psychological symptoms, such as depression In our previous study in 2008, we found that 31% of patients with inflammatory bowel disease (IBD) expressed a subjective need for psychological interventions What are the significant and/or new findings of the study? Despite improvements in therapy, around 30% of patients with IBD express a subjective need for psychological interventionsThis subjective need for psychological interventions is associated with complementary and alternative medicine use and low quality of life Despite improvements in therapy, around 30% of patients with IBD express a subjective need for psychological interventions This subjective need for psychological interventions is associated with complementary and alternative medicine use and low quality of life

Published
2021
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20. Optimising monitoring in the management of Crohn's disease: A physician perspective (vol 7, pg 653, 2013)

Author

Papay, Pavol, Ignjatovic, Ana, Karmiris, Konstantinos, Amarante, Heda, Miheller, Pal, Feagan, Brian, D'Haens, Geert, Marteau, Philippe, Reinisch, Walter, Sturm, Andreas, Steinwurz, Flavio, Egan, Laurence, Panes, Julian, Edouard, Louis, Colombel, Jean-Frederic, Panaccione, Remo, Amsterdam Gastroenterology Endocrinology Metabolism, and Gastroenterology and Hepatology

Published
2014

21. Use of complementary and alternative medicine and low quality of life associate with the need for psychological and psychotherapeutic interventions in inflammatory bowel disease

Author

Kutschera, Maximilian, Waldhör, Thomas, Gröchenig, Hans Peter, Haas, Thomas, Wenzl, Heimo, Steiner, Pius, Koch, Robert, Feichtenschlager, Thomas, Eckhardt, Gerald, Mayer, Andreas, Kirchgatterer, Andreas, Ludwiczek, Othmar, Platzer, Reingard, Papay, Pavol, Gartner, Johanna, Fuchssteiner, Harry, Peters, Paul-Gerhard, Reicht, Gerhard, Moser, Gabriele, Dejaco, Clemens, Vogelsang, Harald, Primas, Christian, Novacek, Gottfried, and Miehsler, Wolfgang

Abstract

Introduction Patients with inflammatory bowel disease suffer from various symptoms, impairing their quality of life and often affecting psychosocial issues. This may lead to the need for additional psychological care. This study investigated patients’ subjective need for integrated psychosomatic support and psychotherapy and indicators for it.Materials and methods This is a cross-sectional multicentre study in Austrian inflammatory bowel disease patients who were in routine care at 18 inflammatory bowel disease outpatient clinics. Patients filled in an anonymous, validated questionnaire (Assessment of the Demand for Additional Psychological Treatment Questionnaire, ADAPT) assessing the need for psychological care. The Assessment of the Demand for Additional Psychological Treatment Questionnaire gives two separate scores: the need for integrated psychosomatic support and for psychotherapy. In addition, health-related quality of life and the use of complementary and alternative medicine as well as clinical and sociodemographic variables were queried. Multivariable regression analysis was performed to estimate the effect of the previously mentioned variables on the need for additional psychological care.Results Of 1286 patients, 29.7% expressed a need for additional psychological care, 19.6% expressed a need for integrated psychosomatic support and 20.2% expressed a need for psychotherapy. In the multivariable analysis, the two strongest indicators for the need for both types of psychological care were the use of complementary and alternative medicine (for integrated psychosomatic support: odds ratio?=?1.64, 95% confidence interval 1.13–2.39, p?=?0.010; for psychotherapy: odds ratio?=?1.74, 95% confidence interval 1.20–2.53, p?=?0.004), and a low health-related quality of life score (for integrated psychosomatic support: odds ratio?=?0.95, 95% confidence interval 0.94–0.96, p?

Published
2024
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22. H1N1 vaccines in a large observational cohort of patients with inflammatory bowel disease treated with immunomodulators and biological therapy.

Author

UCL - (MGD) Service de gastro-entérologie, UCL - SSS/IREC/MONT - Pôle Mont Godinne, UCL - SSS/IREC/GAEN - Pôle d'Hépato-gastro-entérologie, Rahier, Jean-François, Papay, Pavol, Salleron, Julia, Sebastian, Shaji, Marzo, Manuela, Peyrin-Biroulet, Laurent, Garcia-Sanchez, Valle, Fries, Walter, van Asseldonk, Dirk P, Farkas, Klaudia, de Boer, Nanne K, Sipponen, Taina, Ellul, Pierre, Louis, Edouard, Peake, Simon T C, Kopylov, Uri, Maul, Jochen, Makhoul, Badira, Fiorino, Gionata, Yazdanpanah, Yazdan, Chaparro, Maria, UCL - (MGD) Service de gastro-entérologie, UCL - SSS/IREC/MONT - Pôle Mont Godinne, UCL - SSS/IREC/GAEN - Pôle d'Hépato-gastro-entérologie, Rahier, Jean-François, Papay, Pavol, Salleron, Julia, Sebastian, Shaji, Marzo, Manuela, Peyrin-Biroulet, Laurent, Garcia-Sanchez, Valle, Fries, Walter, van Asseldonk, Dirk P, Farkas, Klaudia, de Boer, Nanne K, Sipponen, Taina, Ellul, Pierre, Louis, Edouard, Peake, Simon T C, Kopylov, Uri, Maul, Jochen, Makhoul, Badira, Fiorino, Gionata, Yazdanpanah, Yazdan, and Chaparro, Maria

Abstract

Influenza A (H1N1)v vaccines are well tolerated in patients with IBD. Non-adjuvanted vaccines are associated with fewer local reactions. The risk of IBD flare is probably not increased after H1N1 vaccination.

Published
2011

23. Severe Skin Lesions Cause Patients with Inflammatory Bowel Disease to Discontinue Anti-Tumor Necrosis Factor Therapy.

Author

UCL - (MGD) Service de gastro-entérologie, UCL - SSS/IREC/GAEN - Pôle d'Hépato-gastro-entérologie, Rahier, Jean-François, Buche, Sébastien, Biroulet, Laurent Peyrin, Bouhnik, Yoram, Duclos, Bernard, Louis, Edouard, Papay, Pavol, Allez, Matthieu, Cosnes, Jacques, Cortot, Antoine, Laharie, David, Reimund, Jean-Marie, Lémann, Marc, Delaporte, Emmanuel, Colombel, Jean-Frédéric, Groupe d’Etude Thérapeutique des Affections Inflammatoires du Tube Digestif (GETAID), UCL - (MGD) Service de gastro-entérologie, UCL - SSS/IREC/GAEN - Pôle d'Hépato-gastro-entérologie, Rahier, Jean-François, Buche, Sébastien, Biroulet, Laurent Peyrin, Bouhnik, Yoram, Duclos, Bernard, Louis, Edouard, Papay, Pavol, Allez, Matthieu, Cosnes, Jacques, Cortot, Antoine, Laharie, David, Reimund, Jean-Marie, Lémann, Marc, Delaporte, Emmanuel, Colombel, Jean-Frédéric, and Groupe d’Etude Thérapeutique des Affections Inflammatoires du Tube Digestif (GETAID)

Abstract

BACKGROUND & AIMS:: Psoriasiform and eczematiform lesions are associated with anti-tumor necrosis factor (TNF)-alpha therapies. We assessed clinical characteristics, risk factors, and outcomes of skin disease in patients with inflammatory bowel diseases that presented with psoriasiform and eczematiform lesions induced by anti-TNFalpha agents. METHODS:: We studied 85 patients (69 with Crohn's disease, 15 with ulcerative colitis, and 1 with indeterminate colitis; 62 women) with inflammatory skin lesions (62 psoriasiform and 23 eczematiform lesions). RESULTS:: Twenty-four patients had a history of inflammatory skin lesions and 15 had a familial history of inflammatory skin disease. Locations of eczematiform lesions varied whereas scalp and flexural varieties were mostly psoriasiform. Skin lesions emerged but inflammatory bowel disease was quiescent in 69 patients following treatment with any type of anti-TNFalpha agent (60 with infliximab, 20 with adalimumab, and 5 with certolizumab). Topical therapy resulted in partial or total remission in 41 patients. Patients with psoriasifom lesions that were resistant to topical therapy and that changed anti-TNFalpha therapies once or twice developed recurring lesions. Overall, uncontrolled skin lesions caused 29 patients to stop taking TNFalpha inhibitors. CONCLUSION:: Inflammatory skin lesions following therapy with TNFalpha inhibitors occurred most frequently among women and patients with a personal or familial history of inflammatory skin disease; lesions did not correlate with intestinal disease activity. Recurring and intense skin lesions caused 34% of patients in this study to discontinue use of anti-TNFalpha agents.

Published
2010

27. Mo1256 Role of Fecal Calprotection in Predicting Ileocolonic Endoscopic Recurrence in Postoperative Crohn's Disease

Author

Primas, Christian, primary, Frühwald, Gertrud, additional, Angelberger, Sieglinde, additional, Allerstorfer, David, additional, Papay, Pavol, additional, Eser, Alexander, additional, Gratzer, Cornelia, additional, Dejaco, Clemens, additional, Reinisch, Walter, additional, Novacek, Gottfried, additional, and Vogelsang, Harald, additional

Published
2013
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28. Anti-TNF antibody-induced psoriasiform skin lesions in patients with inflammatory bowel disease are characterised by interferon-γ-expressing Th1 cells and IL-17A/IL-22-expressing Th17 cells and respond to anti-IL-12/IL-23 antibody treatment

Author

Tillack, Cornelia, primary, Ehmann, Laura Maximiliane, additional, Friedrich, Matthias, additional, Laubender, Rüdiger P, additional, Papay, Pavol, additional, Vogelsang, Harald, additional, Stallhofer, Johannes, additional, Beigel, Florian, additional, Bedynek, Andrea, additional, Wetzke, Martin, additional, Maier, Harald, additional, Koburger, Maria, additional, Wagner, Johanna, additional, Glas, Jürgen, additional, Diegelmann, Julia, additional, Koglin, Sarah, additional, Dombrowski, Yvonne, additional, Schauber, Jürgen, additional, Wollenberg, Andreas, additional, and Brand, Stephan, additional

Published
2013
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29. Anogenital Human Papillomavirus Prevalence is Unaffected by Therapeutic Tumour Necrosis Factor-alpha Inhibition.

Author

HANDISURYA, Alessandra, LÁZÁR, Stefanie, PAPAY, Pavol, PRIMAS, Christian, HAITEL, Andrea, HORVAT, Reinhard, TANEW, Adrian, VOGELSANG, Harald, and KIRNBAUER, Reinhard

Subjects
TUMOR necrosis factors, PAPILLOMAVIRUS diseases, DISEASE prevalence, INFLAMMATORY bowel diseases, PHOTOTHERAPY, SEROPREVALENCE, THERAPEUTICS
Abstract

Patients receiving tumour necrosis factor alpha (TNF-α) inhibitors are at increased risk of exacerbation of (myco-)bacterial and some viral infections. However, information on anogenital human papillomavirus (HPV) infection in these patients is sparse or conflicting. In this study 222 patients with psoriasis or inflammatory bowel disease (IBD), who received either anti-TNF-α inhibitors or alternatives (purine-, folic acid analogues, phototherapy, fumaric ester, mesalazine) continuously for at least 6 months, were evaluated for the presence of anogenital HPV-induced lesions, mucosal HPV DNA, and serological status of mucosal low-risk HPV6 and high-risk HPV16/HPV18. Hallmarks of anogenital HPV infection were more frequently detected in patients with psoriasis than in those with IBD. HPV-induced lesions, viral DNA, and seroprevalence were not elevated in participants with psoriasis or IBD, who received TNF-α inhibitors for a mean duration of 31.4 months (range 6-96 months) compared with recipients of alternative or no treatment. TNF-α blockade for a mean period of 31.4 months does not increase detectable anogenital HPV infection or disease. [ABSTRACT FROM AUTHOR]

Published
2016
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34. Granulocyte Activation as Measured by CD64 Expression on Pmns Reflects Inflammatory Activity in Inflammatory Bowel Disease

Author

Eser, Alexander, primary, Primas, Christian, additional, Papay, Pavol, additional, Brehovsky, Sonja, additional, Lichtenberger, Cornelia, additional, Mikulits, Andrea, additional, Angelberger, Sieglinde, additional, Novacek, Gottfried, additional, Vogelsang, Harald, additional, Tillinger, Wolfgang, additional, and Reinisch, Walter, additional

Published
2011
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35. Factors impacting the results of interferon-γ release assay and tuberculin skin test in routine screening for latent tuberculosis in patients with inflammatory bowel diseases

Author

Papay, Pavol, primary, Eser, Alexander, additional, Winkler, Stefan, additional, Frantal, Sophie, additional, Primas, Christian, additional, Miehsler, Wolfgang, additional, Novacek, Gottfried, additional, Vogelsang, Harald, additional, Dejaco, Clemens, additional, and Reinisch, Walter, additional

Published
2011
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39. S1126 Immunosuppressive (IS) Therapy Impacts the Results of QuantiFERON® and Tuberculin Skin Test in Routine Screening for Latent Tuberculosis (LTB) in Patients with Inflammatory Bowel Diseases (IBD)

Author

Papay, Pavol, primary, Eser, Alexander, additional, Miehsler, Wolfgang, additional, Lichtenberger, Cornelia, additional, Mikulits, Andrea, additional, Dejaco, Clemens, additional, Novacek, Gottfried, additional, Vogelsang, Harald, additional, and Reinisch, Walter, additional

Published
2009
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41. 501 Discrepant Results Between Routine Screening for Latent Tuberculosis (Tb) and Quantiferon® in Patients with Inflammatory Bowel Diseases (IBD)

Author

Papay, Pavol, primary, Eser, Alexander, additional, Paulinska, Petra, additional, Lichtenberger, Cornelia, additional, Mikulits, Andrea, additional, Miehsler, Wolfgang, additional, Dejaco, Clemens, additional, Novacek, Gottfried, additional, Vogelsang, Harald, additional, and Reinisch, Walter, additional

Published
2008
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43. Corrigendum to ‘Optimising monitoring in the management of Crohn's disease: A physician perspective’ [Journal of Crohn's and Colitis volume 7 (2013) 653–669]

Author

Papay, Pavol, Ignjatovic, Ana, Karmiris, Konstantinos, Amarante, Heda, Miheller, Pal, Feagan, Brian, D'Haens, Geert, Marteau, Philippe, Reinisch, Walter, Sturm, Andreas, Steinwurz, Flavio, Egan, Laurence, Panés, Julián, EdouardLouis, Colombel, Jean-Frédéric, and Panaccione, Remo

Published
2014
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44. Anti-TNF antibody-induced psoriasiform skin lesions in patients with inflammatory bowel disease are characterised by interferon-?-expressing Th1 cells and IL-17A/IL-22-expressing Th17 cells and respond to anti-IL-12/IL-23 antibody treatment.

Author

Tillack, Cornelia, Ehmann, Laura Maximiliane, Friedrich, Matthias, Laubender, Rüdiger P., Papay, Pavol, Vogelsang, Harald, Stallhofer, Johannes, Beigel, Florian, Bedynek, Andrea, Wetzke, Martin, Maier, Harald, Koburger, Maria, Wagner, Johanna, Glas, Jürgen, Diegelmann, Julia, Koglin, Sarah, Dombrowski, Yvonne, Schauber, Jürgen, Wollenberg, Andreas, and Brand, Stephan

Subjects
TUMOR necrosis factors, IMMUNOGLOBULINS, INFLAMMATORY bowel diseases, INTERFERONS, HISTOLOGY, SKIN diseases
Abstract

Background We analysed incidence, predictors, histological features and specific treatment options of anti-tumour necrosis factor a (TNF-a) antibody-induced psoriasiform skin lesions in patients with inflammatory bowel diseases (IBD). Design Patients with IBD were prospectively screened for anti-TNF-induced psoriasiform skin lesions. Patients were genotyped for IL23R and IL12B variants. Skin lesions were examined for infiltrating Th1 and Th17 cells. Patients with severe lesions were treated with the anti-interleukin (IL)-12/IL-23 p40 antibody ustekinumab. Results Among 434 anti-TNF-treated patients with IBD, 21 (4.8%) developed psoriasiform skin lesions. Multiple logistic regression revealed smoking (p=0.007; OR 4.24, 95% CI 1.55 to 13.60) and an increased body mass index (p=0.029; OR 1.12, 95% CI 1.01 to 1.24) as main predictors for these lesions. Nine patients with Crohn's disease and with severe psoriasiform lesions and/or anti-TNF antibody-induced alopecia were successfully treated with the anti-p40-IL-12/IL-23 antibody ustekinumab (response rate 100%). Skin lesions were histologically characterised by infiltrates of IL-17A/IL-22-secreting T helper 17 (Th17) cells and interferon (IFN)-?-secreting Th1 cells and IFN-a- expressing cells. IL-17A expression was significantly stronger in patients requiring ustekinumab than in patients responding to topical therapy ( p=0.001). IL23R genotyping suggests disease-modifying effects of rs11209026 ( p.Arg381Gln) and rs7530511 (p.Leu310Pro) in patients requiring ustekinumab. Conclusions New onset psoriasiform skin lesions develop in nearly 5% of anti-TNF-treated patients with IBD. We identified smoking as a main risk factor for developing these lesions. Anti-TNF-induced psoriasiform skin lesions are characterised by Th17 and Th1 cell infiltrates. The number of IL-17A-expressing T cells correlates with the severity of skin lesions. Anti-IL-12/IL- 23 antibody therapy is a highly effective therapy for these lesions. [ABSTRACT FROM AUTHOR]

Published
2014
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