Perioperative management of tumor necrosis factor-alpha blocker-treated psoriatic patients: Case reports and review

The Journal of Dermatology
Hiroshi KawakamiYukari Okubo

Abstract

Regarding appropriate timings of discontinuation and resumption of biologics for psoriasis patients before and after elective surgeries, an international consensus has yet to be reached. The Japanese Dermatological Association of Guideline and Safety Manual for the use of Biologic Agents in Psoriasis 2013 states that infliximab (IFX) and adalimumab (ADA) should be withheld at least 4 and 2 weeks, respectively, before surgery and can be restarted as neither postoperative infection nor delayed wound healing is recognized. We experienced three generalized pustular psoriasis (GPP) patients and one plaque-type psoriasis patient undergoing surgeries during tumor necrosis factor (TNF)-α blocker therapy. Three GPP cases experienced uneventful post-surgical course. One psoriasis vulgaris patient on IFX had a wound healing delay with deterioration of psoriatic plaques which was restored by restarting IFX. The timing of suspension and resumption of TNF-α blockers in all cases were determined following the Japanese guideline.

References

Aug 19, 2008·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Hiroko KunitakeLiliana Bordeianou
Oct 28, 2009·The British Journal of Dermatology·C H SmithUNKNOWN (Chair of Guideline Group)
Jan 18, 2012·Archives of Dermatology·Sylvia HsuUNKNOWN National Psoriasis Foundation Medical Board
Sep 17, 2013·The Journal of Dermatology·Mamitaro OhtsukiUNKNOWN Biologics Review Committee of the Japanese Dermatological Association

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Citations

Jan 10, 2018·Immunology·Kazuhisa FurueMasutaka Furue
Jun 18, 2017·Inflammation Research : Official Journal of the European Histamine Research Society ... [et Al.]·Masutaka Furue, Takafumi Kadono
Jul 4, 2020·Expert Opinion on Drug Safety·Wen-Ming Wang, Hong-Zhong Jin

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