What is the evidence that switching from infliximab to certolizumab reduces the risk of paradoxical psoriasis compared to continuing infliximab

What is known

- Certolizumab itself was among the most frequent anti-TNF culprits of paradoxical psoriasis in one cohort ¹. - Paradoxical psoriasis is a recognized class effect of TNF-α inhibitors, and when patients are switched to another anti-TNF agent, roughly half experience recurrence of their lesions ².

What is unknown / caveats

- The retrieved evidence does not establish that switching from infliximab to certolizumab lowers paradoxical psoriasis risk versus continuing infliximab - The certolizumab culprit finding comes from a single cohort

## References

1. Ak T, Mustafayeva L, Ayla AY, Celik Y, Can G, Ugurlu S. Secukinumab after first-line tumor necrosis factor-alpha inhibitor therapy in psoriatic arthritis: A real-world retrospective cohort study. Arch Rheumatol. 2024. PMID: 38774692.

2. Toussirot É, Aubin F. Paradoxical reactions under TNF-α blocking agents and other biological agents given for chronic immune-mediated diseases: an analytical and comprehensive overview. RMD Open. 2016. PMID: 27493788.

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_Draft, generated by the IBDology RAG and not yet clinician-reviewed. Answers are grounded in the retrieved literature listed above; a high faithfulness score means the answer matches its sources, not that the sources are correct._