Imraldi working great but severe psoriasis flare

[Monkeypig]

I’ve been taking Imraldi for a few months with great results, treating AS. However whilst didn’t really suffer before, I’ve developed pretty severe psoriasis/eczema. First thought it was flare but looks like it’s here to stay. Anyone else had this kind of thing? Strange because You would thought biologics would be great treatment for psoriasis, rather than causing it! Making me think that I’d rather tolerate AS symptoms than the bad skin....

[bubblyalex]

I’m not a lot of use here but just wanted to say sorry you have developed that.

[Monkeypig in reply to bubblyalex]

Thank you 😊

[StormySeas]

Hi there

Yes, although to a much lesser extent. I’ve suffered from the same thing with psoriasis and sclerosis (another auto-immune disease).

Mine both come back immediately after a Rituximab infusion although only briefly.

The scleritis also comes back after a course of steroids.

Thinking about it I suppose I could be reacting to the steroid component of the Rituximab treatment (rather than Rituximab itself) but the effect is still the same.

Not sure why - I imagine it’s like a dam being released after symptoms have been suppressed but if it’s long-term like yours it sounds more serious. Do you have a dermatologist? I’d contact the rheumy and ask them if they know about Imraldi causing a psoriasis flare - it might be a known side effect. Failing that, try to get a dermatology referral. Or you could try looking for some scientific papers - I found out some info on RTX and coeliac disease that way, you never know, there might be a known link.

Poor you, I understand how awful it must be. X

[Monkeypig in reply to StormySeas]

Thanks - funnily enough I did read some research papers and there are some cases reported exactly like mine. You have made me wonder as well, I was initially on a course of prednisone for 6 months which I tapered off once the Imraldi started working....this could all be a reaction from stopping the steroids. Thanks for your comments, really helpful 😊

[Barrister]

I remember one time when I was seeing the rheumatologist and he noticed a discoloured patch of skin on my leg, he mentioned that the biologics can make psoriasis worse. But although I have PsA, I don’t actually have psoriasis (yet!) The patch of skin that he had noticed was actually where I had been stung by a jellyfish about 6 months previously.

[Tile]

Some meds lower IL - 6 an inflammatory cytokine. Hydroxychloroquine a med for RA will lower IL - 6 but can induce psorasis or make existing psorasis worse, because of the IL - 6 lowering. Unfortunately. There are other meds that do the same.