The plaque psoriasis drug Humira has been linked to drug-induced lupus erythematosus (DILE) in a case study published in the Journal of Clinical Pharmacy and Therapeutics.
Humira, known chemically as adalimumab, is an immunosuppressant drug that is approved by the Food and Drug Administration (FDA) to treat arthritis, plaque psoriasis, ankylosing spondylitis, Crohn’s disease, and ulcerative colitis.
The case study, detailed by Iva Lomicová, M.D., from Charles University in Pilsen, Czech Republic, and colleagues, involves a patient with severe psoriasis who was treated with adalimumab, but discontinued the medication two weeks prior to having a hysterectomy. A month later, she resumed treatment with adalimumab and shortly thereafter developed swelling, pain and stiffness of the small joints of her hands; paresthesia, tingling, and muscle pain of the extremities; and worsening of psoriasis. Lab tests revealed elevated liver function.
The patient was diagnosed with DILE, a drug-induced type of lupus erythematosus, an autoimmune disease in which the immune system becomes hyperactive and attacks healthy tissue. Symptoms can affect many different body systems, including joints, skin, kidneys, blood cells, heart and lungs, though the condition most often is systemic.
The patient remained on adalimumab until she was able to consult with her rheumatologist. The treatment was then discontinued and the patient’s symptoms though her psoriasis was exacerbated. She was started on Stelara, known chemically as ustekinumab, which nearly cleared her psoriasis completely within two years.
Researchers said the study suggested patients with a genetic susceptibility or history of DILE be treated with Stelara over Humira.