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Management of psoriasis patients with hepatitis B or hepatitis C virus infection

World Journal of Gastroenterology 2016年第28期22卷 6444-6455页

作者： Claudio Bonifati Viviana Lora Dario Graceffa Lorenzo Nosotti center for the study and treatment of psoriasis san gallicano dermatologic institute IRCCS Gastrointestinal and Liver Department National Institute for Health Migration and Poverty

The systemic therapies available for the management of psoriasis (PsO) patients who cannot be treated with more conservative options, such as topical agents and/or phototherapy, with the exception of acitretin, can worsen or reactivate a chronic infection. Therefore, before administering immunosuppressive therapies with either conventional disease-modifying drugs (cDMARDs) or biological ones (bDMARDs) it is mandatory to screen patients for some infections, including hepatitis B virus (HBV) and hepatitis C virus (HCV). In particular, the patients eligible to receive an immunosuppressive drug must be screened for the following markers: antibody to hepatitis B core, antibody to hepatitis B surface antigen (anti-HBsAg), HBsAg, and antibody to HCV (anti-HCV). In case HBV or HCV infection is diagnosed, a close collaboration with a consultant hepatologist is needed before and during an immunosuppressive therapy. Concerning therapy with immunosuppressive drugs in PsO patients with HBV or HCV infection, data exist mainly for cyclosporine a (CyA) or bDMARDs (etanercept, adalimumab, infliximab, ustekinumab). The natural history of HBV and HCV infection differs significantly as well as the effect of immunosuppression on the aforementioned infectious diseases. As a rule, in the case of active HBV infection, systemic immunosuppressive antipsoriatic therapies must be deferred until the infection is controlled with an adequate antiviral treatment. Inactive carriers need to receive antiviral prophylaxis 2-4 wk before starting immunosuppressive therapy, to be continued after 6-12 mo from its suspension. Due to the risk of HBV reactivation, these patients should be monitored monthly for the first 3 mo and then every 3 mo for HBV DNA load together with transaminases levels. Concerning the patients who are occult HBV carriers, the risk of HBV reactivation is very low. Therefore, these patients generally do not need antiviral prophylaxis and the sera HBsAg and transaminases dosing can be

关键词： psoriasis Therapy Conventional disease-modifying drugs Biological disease-modifying drugs Hepatitis B virus infection Hepatitis C virus infection

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Outcomes assessment of hepatitis C virus-positive psoriatic patients treated using pegylated interferon in combination with ribavirin compared to new Direct-Acting Antiviral agents

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World Journal of Hepatology 2018年第2期10卷 329-336页

作者： Giovanni Damiani Chiara Franchi Paolo Pigatto Andrea Altomare Alessia Pacifico Stephen Petrou Sebastiano Leone Maria Caterina Pace Marco Fiore study center of Young Dermatologists Italian Network (YDIN) Gised Bergamo Italy and Clinical Dermatology IRCCS Galeazzi Orthopaedic Institute Department of Biomedical Surgical and Dental Sciences University of Milan Clinical Dermatology IRCCS Galeazzi Orthopaedic Institute san gallicano dermatological institute IRCCS Department of Emergency Medicine St. George’s University Medical School Division of Infectious Diseases "San Giuseppe Moscati" Hospital Department of Anesthe-siological Surgical and Emergency Sciences University of Campania "Luigi Vanvitelli"

AIM To evaluate the outcomes in biological treatment and quality of life of psoriatic patients with chronic hepatitis C(CHC) treated with new Direct-Acting Antiviral agents(DAAs) compared to pegylated interferon-2α plus ribavirin(P/R) *** This is a retrospective study involving psoriatic patients in biological therapy who underwent anti-hepatitis C virus(HCV) treatment at the Department of Dermatology Galeazzi Orthopaedic institute Milan, Italy from January 2010 to November 2017. The patients were divided into two groups: patients that underwent therapy with DAAs and patients that underwent HCV treatment with P/R. Patients were assessed by a dermatologist for psoriasis symptoms, collecting psoriasis Area Severity Index(PASI) scores and the Dermatology Quality of Life Index(DLQI). PASI and DLQI scores were evaluated 24 wk after the end of HCV treatment and were assumed as an outcome of the progression of psoriasis. Switching to a different b DMARD was considered as an inadequate response to biological therapy. The dropout of HCV therapy and sustained virological response(SVR) were considered as outcomes of HCV *** Fifty-nine psoriatic patients in biological therapy underwent antiviral therapy for CHC. Of this, 27 patients were treated with DAAs and 32 with P/R. After 24 wk post treatment, the DLQI and the PASI scores were significantly lower(P treatment. Fewer dermatological adverse events may be due to interferon-free therapy.

关键词： Hepatitis C virus New Direct-Acting Antiviral agents psoriasis Biological disease modifying drugs

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Enthesitis in patients with psoriatic arthritis: A nationwide data from the Chinese Registry of Psoriatic Arthritis (CREPAR)

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Chinese Medical Journal 2023年第8期136卷 951-958页

作者： Fan Yang Chaofan Lu Huilan Liu Lei Dou Yanhong Wang Hongbin Li Xinwang Duan Lijun Wu Yongfu Wang Xiuying Zhang Jian Xu Jinmei Su Dong Xu Jiuliang Zhao Qingjun Wu Mengtao Li Xiaomei Leng Xiaofeng Zeng Department of Rheumatology and Clinical Immunology Peking Union Medical College HospitalChinese Academy of Medical Sciences&Peking Union Medical CollegeNational Clinical Research Center for Dermatologic and Immunologic Diseases(NCRC-DID)Key Laboratory of Rheumatology and Clinical ImmunologyMinistry of EducationBeijing 100730China Department of Rheumatology and Immunology The Second People’s Hospital of WuhuWuhuAnhui 241000China Department of Epidemiology and Biostatistics Institute of Basic Medical SciencesChinese Academy of Medical Sciences&Peking Union Medical CollegeBeijing 100005China The Division of Rheumatology The Affiliated Hospital of Inner Mongolia Medical UniversityHohhotInner Mongolia 010110China Department of Rheumatology The Second Affiliated Hospital of Nanchang UniversityNanchangJiangxi 330006China Department of Rheumatology and Immunology The People’s Hospital of the Xinjiang Uygur Autonomous RegionUrumqiXinjiang 830001China Department of Rheumatology First Affiliated Hospital of Baotou Medical CollegeBaotouInner Mongolia 014010China Department of Rheumatology Zibo Central HospitalZiboShandong 255036China Department of Rheumatology The First Affiliated Hospital of Kunming Medical UniversityKunmingYunnan 650032China

Background:The clinical features of enthesitis in patients with psoriatic arthritis(PsA)have been reported in some Western countries,but data in China are very *** study aimed to describe the characteristics of enthesitis in Chinese patients with PsA and compared them with those in other ***:Patients with PsA enrolled in the Chinese Registry of Psoriatic Arthritis(CREPAR)(December 2018 to June 2021)were *** including demographics,clinical characteristics,disease activity measures,and treatment were collected at *** was assessed by the Spondyloarthritis Research Consortium of Canada(SPARCC),Maastricht ankylosing spondylitis enthesitis score(MASES),and Leeds enthesitis index(LEI)indices.A multivariable logistic model was used to identify factors related to *** also compared our results with those of other ***:In total,1074 PsA patients were included,308(28.7%)of whom had *** average number of enthesitis was 3.3±2.8(range:1.0–18.0).More than half of the patients(165,53.6%)had one or two tender entheseal *** with enthesitis had an earlier age of onset for both psoriasis and arthritis,reported a higher proportion of PsA duration over 5 years,and had a higher percentage of axial involvement and greater disease *** logistic regression showed that axial involvement(odds ratio[OR]2.21,95%confidence interval[CI],1.59–3.08;Ppsoriasis area and severity index(PASI)(OR:1.03,95%CI:1.01–1.04;P=0.002),and disease activity score 28-C reactive protein(DAS28-CRP)(OR:1.25,95%CI:1.01–1.55;P=0.037)were associated with *** with the results of other studies,Chinese patients with enthesitis had a younger age,lower body mass index(BMI),a higher rate of positive human leukocyte antigen(HLA)-B27,more frequent dactylitis,and a higher proportion of conventional synthetic disease-modifying antirheumatic drugs’(csDMARDs)***:Enthesitis is a common condit

关键词： Enthesitis Psoriatic arthritis Registry

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