Found this over at Rheumorweb
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Rheumatoid Arthritis Drugs Tied to Skin Problems

Study Links Humira, Remicade, and Enbrel to Skin Conditions

Dutch researchers have linked a group of rheumatoid
arthritis drugs to skin problems.

HumiraHumira (adalimumab), RemicadeRemicade
(infliximab), and EnbrelEnbrel (etanercept) are
mentioned in the study, which appears in the journal
Arthritis Research and Therapy.

All of those medications are biologic treatments for
rheumatoid arthritis (RA). They are a new type of
treatment approacha new type of treatment approach that
inhibits TNF, a chemical made by the body to induce
inflammation. These chemical substances lead to joint
inflammation seen in RA.

The study "shows that dermatological conditions are a
significant and clinically important problem in RA
patients receiving TNF-alpha-blocking therapy," write
the researchers.

Out of 289 RA patients taking biologic agents, 72 (25%)
consulted a dermatologist about skin problems over an
average of two years. In comparison, in a group of RA
patients who had never received these drugs, 37 (13%)
consulted a dermatologist. The comparison group tended
to have less severe cases of RA, say the researchers.

Most Common Problems

There were a total of 128 skin problems among the 72
patients taking biologic agents who had consulted a
dermatologist. Their most common conditions were skin
infections (33 cases), eczema (20 cases), and
drug-related skin eruptions (15 cases). None required
hospitalization but seven patients decided to stop
taking the drugs because of skin problems.

The number of skin problems reported during or after
treatment was 56 for Humira, 49 for Remicade, and 16
for Enbrel, write the researchers, who included Marcel
Flendrie of Radboud University Njimegen Medical Centre
in the Netherlands.

Most of the skin eruptions occurred in the first five
months of treatment with the biologic agents and were
caused by all of the drugs, the researchers report.
Reports of skin problems had surfaced in study trials
of the drugs but this is the first large study that
tracked problems as they unfolded, say Flendrie and
colleagues.

Who Took What Drugs

The group included 70 patients who were taking more
than one TNF blocker. Eight patients took more than two
anti-TNF drugs, say researchers.

Humira was taken by 108 patients, Remicade by 167, and
Enbrel by 78 people
"Based on the information in the article, we really
can't address [the study]," says Candace Steele,
director of global public relations for Wyeth
Pharmaeuticals, which markets Enbrel in the U.S.
together with the drug company Amgen.

"I can tell you that we have seen dermatological
effects with some patients who've used Enbrel," says
Steele. "Essentially, if a physician were to contact us
about dermatological effects, we have standard
information [stating that] skin rash has been described
in clinical trials, postmarketing experience, and
literature reports."

Patients should report any skin conditions to their
doctors, she adds.

"Injection site reaction is a possible side effect
that's listed in our label. In fact, it's in the label
of all TNF inhibitors,it's in the label of all TNF
inhibitors," says Jim Bozikis, manager of
pharmaceutical public affairs for Abbott Laboratories,
which makes Humira.

"Our experience with RA patients and Humira is that
when side effects do occur, they're so mild that
patients choose to continue therapy because the
benefits greatly outweigh any side effects," he says.

"In general, with anti-TNF therapy, patients are more
susceptible to infection and the key is for patients to
work closely with their physicians and carefully
monitor their progress," says Bozikis.

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SOURCES: Flendrie, M. Arthritis Research and Therapy,
April 3, 2005. News release, BioMed Central. Candace
Steele, director, global public relations, Wyeth
Pharmaceuticals. Jim Bozikis, manager, pharmaceutical
public affairs, Abbott Laboratories