Psoriasis and Multiple Sclerosis and The Role of B-Cell Depletion

The incidence of psoriasis is higher in patients with multiple sclerosis (MS) who are treated with B-cell depleting therapies compared with other MS therapies, according to study results presented at the 2021 Annual Meeting of the Consortium of Multiple Sclerosis Centers (CMSC), held October 25 to 28, 2021 in Orlando, Florida.

Patients with MS may experience a higher incidence of psoriasis compared with the general population. There are disease-modifying therapies (DMTs) used in the treatment of MS that target certain pathways shared by both MS and psoriasis. The current study authors speculate that the risk of developing psoriasis in this patient population may be associated with the use of DMTs with its occurrence varying by the drug.

The objective of the current study was determine psoriasis risk in patients with MS based on the use of certain DMTs.

Researchers analyzed the US Food and Drug Administration (FDA) Adverse Event Reporting System for reports of psoriasis between 2009 and 2020. They focused their analysis on psoriasis cases attributed to ocrelizumab, interferon beta-1a, interferon beta-1b, glatiramer acetate, dimethyl fumarate, fingolimod, teriflunomide, alemtuzumab, natalizumab, and rituximab. In total, the researchers identified 517 reports of psoriasis in 45,547 reports in skin and subcutaneous tissue disorders.

The incidence of psoriasis was proportionally higher in patients treated with rituximab (6.5%) and ocrelizumab (3%) compared with glatiramer acetate (0.3%), teriflunomide (0.5%), alemtuzumab (0.5%), and dimethyl fumarate (0.6%). A higher proportion of patients drove reporting for DMTs (57%) compared with clinicians. The researchers note that the reports for psoriasis cases were higher in the 5^th and 6^th decades of life as well as among female patients (0.71).

Based on these findings, the researchers note that the observations were “in line with reports from rheumatology and other medical fields where either de novo psoriasis or exacerbation of known psoriasis had been observed in association with B-cell depletion.”

Despite the findings, the researchers point out that they could not determine risk or causality in regard to B-cell depletion in MS and psoriasis incidence. “In PwMS [people with MS] and comorbid psoriasis, treated with B-cell depleting agents, monitoring psoriasis activity is encouraged.”

Disclosure: Multiple authors declared affiliations with the pharmaceutical industry. Please refer to the original article for a full list of disclosures.

Reference

Porwal MH, Patel D, Maynard M, Obeidat AZ. Psoriasis in multiple sclerosis patients treated with disease-modifying therapies. Presented at: CMSC 2021 Annual Meeting; October 25-28, 2021; Orlando, Florida. Abstract DMT51.