title: Thrombocytopenia associated with the use of anti-tumor necrosis factor-alpha agents for psoriasis.
abstract: BACKGROUND
  Thrombocytopenia has been reported to be associated with efalizumab therapy, but has only sporadically been reported with other anti-tumor necrosis factor alfa (TNF-alpha) agents.
  
  
  OBJECTIVE
  To describe the frequency of thrombocytopenia in a cohort of patients who underwent biological therapies for psoriasis.
  
  
  METHODS
  This was a retrospective observational study of 93 patients.
  
  
  RESULTS
  One hundred eighteen courses of biological therapies were administered to 93 patients. Four of 67 patients who received anti-TNF-alpha agents developed drug-induced thrombocytopenia during treatment, compared with none of the 51 patients receiving efalizumab therapy. The platelet count recovered after suspension of anti-TNF-alpha agents in 3 patients and relapsed after re-exposure in two patients. The overall estimated frequency of thrombocytopenia in our cohort was 4.30% (95% confidence interval [CI], 0% to 6.2%).
  
  
  CONCLUSIONS
  These findings should be validated in larger studies.
  
  
  CONCLUSIONS
  Drug-induced thrombocytopenia is a potential side effect of anti-TNF-alpha agents. Immediate monitoring of platelet counts is recommended if autoimmunity is suspected.
authors.affiliation: Department of Dermatology, Galliera Hospital, Genoa, Italy.
authors.forename: Alexandra Maria Giovanna
authors.initials: AM
authors.lastname: Brunasso
authors.forename: Cesare
authors.initials: C
authors.lastname: Massone
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D015535:Arthritis, Psoriatic / Q000188:drug therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D011565:Psoriasis / Q000188:drug therapy*; D012189:Retrospective Studies; D013921:Thrombocytopenia / Q000139:chemically induced*; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D014409:Tumor Necrosis Factor-alpha; C472181:efalizumab