In a current thread on adverse reactions to IFN, one member who shares with me an extreme adverse autoimmune reaction notes having history of psoriasis. I also had a mild psoriasis case before starting IFN. Mine was localized, intermittent and well controlled with OTC meds and I thought nothing of it
Question for other members now or before on IFN is what is your history with psoriasis? and how well did/are you tolerating the IFN?
No history of psoriasis, but positive for eczema. The IFNs did not have any effect on eczema flares but has caused itching and occasional rashes that are clearly not eczema. Fortunately, a daily dose of cetirizine manages this issue nicely.
No further replies so far. Eczema seems to be not an A-I condition so it is reasonable that it would not add A-I risk to IFN. Psoriasis is A-I and in fact one drug that treats one type is in ph 3 for Sjo. Could be even mild psoriasis is worth considering when starting IFN. Hope to hear more replies.
I have a long history with psoriasis. Initially just occasional flare ups, but then a few years before my ET diagnosis it became chronic on my scalp. As my HU dose increased in my first years of treatment I noticed my psoriasis went dormant - one of the only good thing of my HU treatment. My derm told me HU is an off label treatment for psoriasis. But due to my intolerability/resistance to HU, I am in the process of switching to Pegasys and had my first dose 5 days ago. I am really worried about what this may do to my sleeping psoriasis when I am taken off the HU. I too have heard others share that their psoriasis came back, but much worse than before. I am hoping that is not the case for me. I too would like to hear others experiences.
I see patients that are on other immunotherapies for cancer and I have seen psoriasis break outs or flares. I know it isn’t INF, but I have seen those reactions on other similar type medications. And I have been able to treat them so they can stay on their therapy. Not sure if this would apply to INF, but just thought I would share.
Bikelove below here found a quite relevant report. The concern is association of prior pso history to later Sjo incidence. You note there may be one in the other direction, prior biologicals and later pso. As you also note most Pso is readily treatable, mine responded fully to OTC creme. But in the other direction, Sjo is usually not treatable, so we do want to keep watching that risk.
Absolutely, I completely agree. Sometimes the risk is too much. I think it is a case by case scenario. Did you get to try sotyktu? I have a patient coming in next week that I started has PSO and Sjo. Going to be interesting to see what she says
Sotyktu (Jak4-Tyk2 ) may be problematic with Rux (Jak1+2). It's an exclusion in the trial but in clinic maybe not. There is one pt on the Sjo forum that may get to try. But off label the 250,000 I assume it costs would be a problem.
Sotyktu never had a phase 2 for Sjo they extrapolated from a ph2 for SLE. So your pt's result will be quite interesting. I assume it takes a while to effect. I think the indication is plaque Pso. Maybe I'd like to get some if that to try Sotyktu. My mild Pso has been absent since on Rux.
My understanding is Sotyktu acts on the IFN signal, so pts that get to Sjo via IFN might benefit well.
This is a bit like your opportunity to try Plegridy, but I recall your MS does not require Tx anyway.
I will keep you posted on my patient and her progress. And we will see what’s up with my MS in April. Will likely have another MRI. I’m am hoping I can talk my way out of it but we will see. I’m am doing so well not sure what it will change but will see if neurologist thinks I can go another year which is my vote!
I don’t have psoriasis, but I have Sjogren’s. I saw this interesting article and I thought of you.
sjogrenssyndromenews.com/ps...
Thank you for this amazingly timely and very recent report. You should post on SP, if you don't feel up for it I can, let me know.
I've not read the details, I hope to soon. With a history of psoriasis the hazard ratio (HR) is 1.5 for getting Sjo. I think they defined pso as having at least two episodes, it seems severity is not clearly specified.
Of further relevance here, they found use of biological agents had HR=1.66 for Sjo. They refer to dermatological drugs, but IFN is also one and we already know it has a Sjo connection. Finally psoriatic arthritis (PsA) had Sjo HR of 2.27.
My take on the message is, two Voice members with Pso history and extreme IFN reactions, and this report, if one has pso history, and especially PsA, consider carefully before starting IFN.
IFN or Rux?
