The risk of deep fungal infections during biologic therapy for psoriasis

Abstract

With a growing understanding of the pathogenesis and immunological basis of psoriasis, the medical community has seen the development of more focused biological treatment options for patients suffering from the disease, which are beginning to revolutionize the treatment of psoriasis. It is already well known that certain biologics are associated with an increased risk of reactivating tuberculosis in patients with latent disease, however, with increasing use of biologic agents across indications, there has also been a rise in reports of associated deep fungal infections. The mechanism of action of these biologic anti-psoriatic therapies allows physicians to address the underlying cause of patients' symptoms. The question though, is whether this same therapeutic mechanism may predispose patients to serious infections, including deep fungal infections.

Rate of serious infection in patients who are prescribed systemic biologic or nonbiologic agents for psoriasis: A large, single center, retrospective, observational cohort study

“…Patients on either adalimumab or infliximab in RA populations also have been reported to have increased rates of Legionella pneumonia (Bodro, Carratala, & Paterson, 2014). Reactivation of latent tuberculosis (TB), as well as increased susceptibility to systemic deep fungal infection (Jourabchi, Adelzadeh, & Wu, 2014) (Bongartz et al, 2006;Leombruno et al, 2009 Bodro et al, 2014;Kalb et al, 2015;Kim et al, 2015;Reich et al, 2015;Sanz-Bueno et al, 2015;Yun et al, 2015).…”

Infections in the era of immunobiologicals

“…There was one case of coccidioidomycosis in a patient using adalimumab, and no severe fungal infections were reported. 57 …”

Μελέτη Της Μυκητιασικής Χλωρίδας Των Ψωριασικών Πλακών

“…Μάλιστα, η εμφάνιση μίας μονήρους βλάβης στο δέρμα προσομοίαζε περισσότερο με βασικοκυτταρικό καρκίνωμα και μόνο μετά από αφαίρεση και βιοψία ανακαλύφθηκε ότι επρόκειτο για μυκητίαση. 135 Σε άλλη αναφορά γίνεται λόγος για προδιάθεση σε εν τω βάθυ λοιμώξεις ασθενών με ψωρίαση υπό βιολογικό παράγοντα.…”