Thrombocytopenia associated with the use of anti-tumor necrosis factor-alpha agents for psoriasis

J Am Acad Dermatol. 2009 May;60(5):781-5. doi: 10.1016/j.jaad.2008.12.001. Epub 2009 Feb 13.

Abstract

Background: Thrombocytopenia has been reported to be associated with efalizumab therapy, but has only sporadically been reported with other anti-tumor necrosis factor alfa (TNF-alpha) agents.

Objective: To describe the frequency of thrombocytopenia in a cohort of patients who underwent biological therapies for psoriasis.

Methods: This was a retrospective observational study of 93 patients.

Results: One hundred eighteen courses of biological therapies were administered to 93 patients. Four of 67 patients who received anti-TNF-alpha agents developed drug-induced thrombocytopenia during treatment, compared with none of the 51 patients receiving efalizumab therapy. The platelet count recovered after suspension of anti-TNF-alpha agents in 3 patients and relapsed after re-exposure in two patients. The overall estimated frequency of thrombocytopenia in our cohort was 4.30% (95% confidence interval [CI], 0% to 6.2%).

Limitations: These findings should be validated in larger studies.

Conclusions: Drug-induced thrombocytopenia is a potential side effect of anti-TNF-alpha agents. Immediate monitoring of platelet counts is recommended if autoimmunity is suspected.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antibodies, Monoclonal / therapeutic use
  • Antibodies, Monoclonal, Humanized
  • Arthritis, Psoriatic / drug therapy
  • Female
  • Humans
  • Male
  • Middle Aged
  • Platelet Count
  • Psoriasis / drug therapy*
  • Retrospective Studies
  • Thrombocytopenia / chemically induced*
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors*

Substances

  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Tumor Necrosis Factor-alpha
  • efalizumab