Successful treatment of psoriasis with risankizumab in an HIV positive patient with sexually transmitted infection comorbidities

Abstract

The management of psoriasis in HIV-positive patients is challenging, particularly as data on biologic therapy safety and efficacy in HIVpositive patients are limited. 1 Risankizumab is a humanized IgG1 monoclonal antibody targeting the p19 subunit of interleukin-23 (IL-23) approved to treat psoriasis. Risankizumab was generally well tolerated in clinical trials and found to be relatively safe. Thus, it could be a suitable treatment for patients with chronic infections such as HIV. 2 Our case involves a 36-year-old man having sex with men (MSM) with chronic hepatitis C (without replication activity) and HIV infec-

Risankizumab, a therapeutic alternative for psoriasis in people living with HIV

“…The positive balance between benefits and risks, observed in both long-term studies and case reports of PLHIV (Table 1), reinforces their potential as effective and safe treatments for psoriasis in individuals with HIV. [22][23][24][25] Further research and larger studies involving this specific cohort are needed to better understand the long-term safety and efficacy of IL-23 inhibitors in people affected by HIV. Nevertheless, these findings contribute to the progression and evolution of psoriasis management in immunocompromised individuals, providing hope for better outcomes in this challenging patient group.…”

“…21 Seven cases of PLHIV with psoriasis treated with risankizumab have been reported (Table 1). [22][23][24] In all seven cases, the treatment with risankizumab was effective, welltolerated and no significant adverse events were recorded. [22][23][24] In addition, a PLHIV with psoriasis treated with guselkumab, another IL-23 inhibitor, has been reported (Table 1).…”

“…[22][23][24] In all seven cases, the treatment with risankizumab was effective, welltolerated and no significant adverse events were recorded. [22][23][24] In addition, a PLHIV with psoriasis treated with guselkumab, another IL-23 inhibitor, has been reported (Table 1). 25 The treatment proved effective, with no reported adverse events, and both viral load and CD4 count remained stable throughout the treatment period.…”

Use of risankizumab in two HIV-positive patients with psoriasis

“…This patient had complete clearance of their psoriasis and no worsening of their HIV immunological parameters. 4 Risankizumab is a humanized IgG1 monoclonal antibody targeting the p19 subunit of IL-23 approved for the treatment of psoriasis and psoriatic arthritis. Our report of 2 patients being successfully treated with risankizumab, adds to the literature that selective inhibition of IL-23 appears to be a suitable therapeutic option for this patient population.…”

Effectiveness and safety of risankizumab in HIV patients with psoriasis: A case series

“…[12][13][14] Additionally, two case reports of patients treated with IL-23 inhibitors during chronic HIV infection have been reported in the literature. 15,16 In a recent meta-analysis, risankizumab was found to have high efficacy and low risk compared with other biologics currently available for psoriasis management, even in a long-term evaluation. 17…”