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TNFα inhibitor biosimilars associated with alopecia areata. Case-based review

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Abstract

Alopecia areata (AA) is a common non-scaring hair loss associated with many inflammatory and autoimmune disorders. Anti-tumor necrosis factor alpha (TNFα) therapy is used to treat many chronic inflammatory disorders and has been proven to be effective and relatively safe. However, several immune-mediated skin reactions have been described with the use of TNFα inhibitors, among them AA. In this report, we describe two patients, a 32-year-old woman with ankylosing spondylitis and a 48-year-old man with rheumatoid arthritis who were both treated with SB4 (Benepali®), an etanercept biosimilar, and developed AA, 6 and 12 months respectively after the initiation of TNFα blocker biosimilar. These, are the first two cases of AA development during TNFα inhibitors biosimilar. Thus, physicians when dealing with patients treated with these agents, should be aware of possible immune skin reactions, among them AA. To this end, a close follow-up and monitoring is mandatory.

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Acknowledgements

The authors thank Ms. Chrysa Arvaniti for her excellent secretarial assistance.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial or non-profit sectors.

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Authors and Affiliations

  1. Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina, 45110, Ioannina, Greece

    E. Pelechas, P. V. Voulgari & A. A. Drosos

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  1. E. Pelechas
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  2. P. V. Voulgari
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  3. A. A. Drosos
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Contributions

All authors have made a substantial contribution to the current manuscript and have approved the final version fulfilling all the four criteria requested by the ICNJE. EP: drafting, PVV revision, AAD: conception of the work, revision.

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Correspondence to A. A. Drosos.

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All authors (E. Pelechas, PV. Voulgari & AA. Drosos) declare no conflicts of interest.

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As per our institution’s ethic’s approval, when there is no sensitive data of the patient presented (face characteristics, name/surname/date of birth on photos/x-rays/ct/mri etc.) there is no need for a specific approval.

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Pelechas, E., Voulgari, P.V. & Drosos, A.A. TNFα inhibitor biosimilars associated with alopecia areata. Case-based review. Rheumatol Int 42, 1113–1117 (2022). https://doi.org/10.1007/s00296-022-05129-w

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  • DOI: https://doi.org/10.1007/s00296-022-05129-w

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