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Enbrel treatment for psoriasis may be associated with an increased risk for multiple squamous cell carcinomas (SCCs), suggest results from a case series and review of the literature.
There is some prior evidence to suggest that anti-tumor necrosis factor drugs such as Enbrel may increase the risk for skin cancers such as SCC, but reports to date have been conflicting.
Writing in the International Journal of Dermatology, Jerry Brewer (Mayo Clinic, Rochester, Minnesota, USA) and colleagues describe four cases of patients with psoriasis and multiple SCCs thought to be a result of Enbrel treatment.
The patients in the series were aged 53 to 85 years and all had lifelong psoriasis. The mean time to first SCC onset was 11 months (range 1-17 months) after beginning Enbrel therapy, with all patients having between five and more than 50 SCCs in total and three of the four patients having aggressive grade III or IV SCCs.
The four psoriasis patients did not have a family history of skin cancer, but all four had previously had SCCs before using Enbrel.
Brewer and team reviewed the literature to evaluate previous reports of links between Enbrel and SCC. They found four further reports of psoriasis patients (n=10) who were treated with Enbrel going on to develop SCC, in one case in addition to non-Hodgkin lymphoma.
In contrast, another study found no increased risk for SCC with Enbrel treatment in 1440 patients with psoriasis. In addition, mice deficient in tumor-necrosis factor-α were shown to be resistant to skin cancer in a further study.
"Although some studies suggest there is no increased risk of cutaneous malignancy in patients treated with Enbrel, more research is needed to better characterize the effect of Enbrel on the development of SCCs in patients with psoriasis," say Brewer and co-authors.
"Until further research is available, sun-protective behavior, education into skin cancer prevention, and regular self-examinations and dermatologic examinations are warranted for patients with psoriasis treated with Enbrel," they conclude.
Source: medwire-news.md
There is some prior evidence to suggest that anti-tumor necrosis factor drugs such as Enbrel may increase the risk for skin cancers such as SCC, but reports to date have been conflicting.
Writing in the International Journal of Dermatology, Jerry Brewer (Mayo Clinic, Rochester, Minnesota, USA) and colleagues describe four cases of patients with psoriasis and multiple SCCs thought to be a result of Enbrel treatment.
The patients in the series were aged 53 to 85 years and all had lifelong psoriasis. The mean time to first SCC onset was 11 months (range 1-17 months) after beginning Enbrel therapy, with all patients having between five and more than 50 SCCs in total and three of the four patients having aggressive grade III or IV SCCs.
The four psoriasis patients did not have a family history of skin cancer, but all four had previously had SCCs before using Enbrel.
Brewer and team reviewed the literature to evaluate previous reports of links between Enbrel and SCC. They found four further reports of psoriasis patients (n=10) who were treated with Enbrel going on to develop SCC, in one case in addition to non-Hodgkin lymphoma.
In contrast, another study found no increased risk for SCC with Enbrel treatment in 1440 patients with psoriasis. In addition, mice deficient in tumor-necrosis factor-α were shown to be resistant to skin cancer in a further study.
"Although some studies suggest there is no increased risk of cutaneous malignancy in patients treated with Enbrel, more research is needed to better characterize the effect of Enbrel on the development of SCCs in patients with psoriasis," say Brewer and co-authors.
"Until further research is available, sun-protective behavior, education into skin cancer prevention, and regular self-examinations and dermatologic examinations are warranted for patients with psoriasis treated with Enbrel," they conclude.
Source: medwire-news.md