Is it ever reasonable to switch to a different TNFi as opposed to switching to an agent in a different class in a case of TNFi induced lupus or psoriasis?

This is a very interesting question where the answer continues to evolve. I would also like to answer the question separately. Both Psoriatic skin lesions and lupus or lupus-like conditions can be induced by anti-TNF-alpha therapy. The pathogenesis may involve changes in cytokine balance.

Regarding Psoriatic skin lesions, the data is highly suggestive that it is de Novo effect and not an exacerbation of underlying psoriasis {1}. Data suggests that the risk is increased 5-10 times the baseline and...