A case of Tuberculosis in a patient on Efalizumab and Etanercept for treatment of refractory palmopustular psoriasis and psoriatic arthritis

Kitamura, Gene; Mehr, Neda; Anderson, Nancy; Sirichotiratana, Melissa

doi:10.5070/d31hd646hw

Cited by 9 publications

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“… 1 , 2 Combination biologic therapy has been rarely reported for the treatment of psoriasis ( Table I ). 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 The potential rationale for this approach in patients with psoriasis can be understood by examining the pathophysiology of the condition. 3 A chronic inflammatory immune-mediated condition, there are several other proinflammatory mediators involved in psoriasis, including IL-17, interferon gamma, TNF-alfa, and IL-23.…”

Section: Discussionmentioning

confidence: 99%

“… 3 , 7 In Gniadecki et al’s 6 long-term case series observational study, they noted an increased frequency of infections including herpes zoster virus and retrotonsillar abscess. Kitamura et al 8 report a case of tuberculosis in a patient on efalizumab and etanercept. In terms of other potential adverse effects, Babalola et al 4 reported a cardiovascular event in a patient receiving dual biologic therapy (etanercept and ustekinumab), but they proposed that the event could not be definitively attributed to the treatment regime.…”

Section: Discussionmentioning

confidence: 99%

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The use of dual biologic therapy for the management of recalcitrant psoriasis

Finnegan,

Murphy,

Bourke

2024

JAAD Case Reports

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The use of dual biologic therapy for the management of recalcitrant psoriasis

Finnegan,

Murphy,

Bourke

2024

JAAD Case Reports

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Combining Biologic Therapies With Other Systemic Treatments in Psoriasis

et al. 2015

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The Efficacy of Biologic Therapy for the Management of Palmoplantar Psoriasis and Palmoplantar Pustulosis: A Systematic Review

Sanchez

Sorenson

Levin

et al. 2017

Dermatol Ther (Heidelb)

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IntroductionPalmoplantar psoriasis (PP) and palmoplantar pustulosis (PPP) are diseases affecting the hands and/or feet that can cause marked physical discomfort and functional disability. The tumor necrosis factor-alpha antagonists adalimumab, etanercept, and infliximab, the interleukin (IL)-17A inhibitors ixekizumab and secukinumab, and the IL-23 or IL-12/IL-23 inhibitors guselkumab and ustekinumab have been well studied for the treatment of moderate to severe plaque psoriasis. Less is known about the efficacy and safety of these agents for the treatment of PP (hyperkeratotic and pustular forms) and PPP. The aim of this review was to investigate the efficacy of biologic therapy for the treatment of hyperkeratotic PP, pustular PP, and PPP.MethodsA systematic search of the medical electronic databases (Medline, Embase, and Cochrane Library) was conducted to identify studies or case reports which both used biologic therapy for the treatment of hyperkeratotic PP, pustular PP, and PPP and reported treatment outcomes.ResultsThe systematic search identified 579 published articles, of which 44 were included in the analysis. Seven of the articles involved randomized placebo-controlled trials, two were open label trials, and the remaining were cohort studies, case series, or case reports. In the randomized controlled trials on the treatment of hyperkeratotic PP, adalimumab, guselkumab, infliximab, ixekizumab, and secukinumab each demonstrated superiority to placebo at 16, 16, 14, 12, and 12 or 16 weeks, respectively (p < 0.05). For the treatment of pustular PP, ustekinumab 45 mg was not superior to placebo at 12 and 16 weeks, respectively (p > 0.05), although an open label study demonstrated that four of five patients on a therapeutic regimen of ustekinumab 90 mg achieved clinical clearance at 16 weeks. For the treatment of PPP, etanercept and ustekinumab 45 mg were not superior to placebo at 12 and 16 weeks, respectively (p > 0.05). A combined analysis of studies for hyperkeratotic PP demonstrated that 94.7%, 90.0%, 82.5%, 89.1%, and 86.7% of patients experienced an improvement of at least 50% upon treatment with adalimumab, guselkumab, ixekizumab, secukinumab, and ustekinumab, respectively. In a combined analysis of case reports examining PPP, infliximab showed the greatest efficacy at 100.0% clinical improvement of patients from case reports, followed by ustekinumab at 58.8% clinical improvement. Few serious adverse events were reported, but several were reported in patients treated with infliximab or secukinumab.ConclusionBiologic therapy is effective and well-tolerated for the treatment of hyperkeratotic PP, but less data are available on the treatment of pustular PP or PPP. Adalimumab, guselkumab, ixekizumab, secukinumab, and ustekinumab all showed > 80% efficacy for the treatment of hyperkeratotic PP, while infliximab and ustekinumab showed moderate efficacy for the treatment of pustular PP, and infliximab was the most efficacious treatment for PPP.Electronic supplementary materialThe online version of this article...

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A case of Tuberculosis in a patient on Efalizumab and Etanercept for treatment of refractory palmopustular psoriasis and psoriatic arthritis

Cited by 9 publications

References 0 publications

The use of dual biologic therapy for the management of recalcitrant psoriasis

The use of dual biologic therapy for the management of recalcitrant psoriasis

Combining Biologic Therapies With Other Systemic Treatments in Psoriasis

The Efficacy of Biologic Therapy for the Management of Palmoplantar Psoriasis and Palmoplantar Pustulosis: A Systematic Review

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