Biologics in Leprosy: A Systematic Review and Case Report.

The American Journal of Tropical Medicine and Hygiene
Anna L CogenStephen L Walker

Abstract

Tumor necrosis factor (TNF)-α inhibitors increase susceptibility to tuberculosis, but the effect of biologics on susceptibility to leprosy has not been described. Moreover, biologics may play a role in treating erythema nodosum leprosum (ENL). The objectives of this systematic review were to determine whether the development of clinical leprosy is increased in patients being treated with biologics and to assess the use of biologics in treating leprosy reactions. A systematic literature review was completed of patients with leprosy who received treatment with biologics either before or after a diagnosis of leprosy was confirmed. All studies and case reports were included for qualitative evaluation. The search yielded 10 cases (including one duplicate publication) of leprosy diagnosed after initiation of TNF-α inhibitors and four case reports of refractory ENL successfully treated with infliximab or etanercept. An unpublished case of persistent ENL responsive to infliximab is also presented. These data demonstrate that the use of TNF-α inhibitors may be a risk factor for developing leprosy or reactivating subclinical infections. Leprosy can present with skin lesions and arthritis, so leprosy should be considered in patients prese...Continue Reading

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Citations

Oct 2, 2020·Current Opinion in Ophthalmology·Sivaraman Bala MuruganYogish Kamath
Mar 5, 2021·Immunological Reviews·Linda B Adams
May 8, 2021·International Journal of Dermatology·Julie ValentinRomain Blaizot

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