TNF has been shown to be effective in treating intractable acne and may also induce acne

Tumor necrosis factor alpha inhibitors (TNFis) have been found to be effective in treating intractable acne, but recent systematic studies suggest that they may be associated with acne development in some cases. Suggested in the reviews.1

TNF-α inhibitors, which are approved for the treatment of inflammatory diseases, are sometimes used off-label for severe acne that does not respond to conventional treatments. However, their use may promote the development of acne, indicating a possible association between TNFis and acne.

As much of the available literature on this subject consists of unreviewed case reports, researchers chose to investigate this relationship further. This review was authored by his Aaron Gabriel W. Sandoval, MPhil, MSc from Harvard Medical School.

“Given the elevation of cytokines such as tumor necrosis factor alpha (TNF), interleukin-17, and interleukin-1β in acne, TNF inhibitors (TNFis) may be a setting for severe, refractory acne or inflammatory syndromes.” writes Sandoval and colleagues. “However, acne development after TNFi use in other conditions has also been reported.”

The researcher’s review of the literature describes available research related to the use of TNFi in both the treatment and development of acne.2

Investigators conducted a systematic review of the available literature using PubMed and Web of Science searches with articles published from inception to October 2022 in these databases.

They included studies in their review that reported on patients of any age or sex who received TNFis and developed or resolved acne. The team also used two reviewers to independently assess studies, extract data from each, and analyze them quantitatively.

Overall, the investigators found that out of the 53 studies included, there were a total of 64 patients who received TNFi for acne treatment or developed acne after TNFi treatment for another problem. We found that the mean age of patients was 28.7 years and 8.8% were female.

The researchers concluded that approximately 93.6% of patients receiving TNFis etanercept, adalimumab, or infliximab experienced partial improvement or resolution of their acne (53.2% and 40.4%, respectively).

They found that only about 6.4% of these patients reported any adverse effects. I noticed that

The team noted that out of 17 patients who developed acne after TNFi treatment for another condition, only one patient had a history of acne. In most cases, discontinuing or adjusting her TNFis after the onset of acne led to symptomatic improvement.

“Further studies elucidating the role TNF plays in the treatment and induction of acne may provide insight into off-label TNFi use and acne etiology, and guide clinical care for patients with TNFis-treated or induced acne.” There is,” they wrote.

  1. Sandoval AGW, Vaughn LT, Huang JT, Barbieri JS. Role of tumor necrosis factor alpha inhibitors in acne treatment and development: a systematic review. JAMA DermatologyPublished online March 17, 2023. doi:10.1001/jamadermatol.2023.0269.
  2. Hajime Kurokawa, Leighton AM, and Ogawa R. The latest in acne treatment: Targeted therapy based on etiology. Dermatol Ther (Heidelv)2021;11(4):1129-1139. doi:10.1007/s13555-021-00552-6.

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