Efectos adversos observados durante la terapia biológica en la psoriasis. Resultados de una encuesta al Grupo Español de Psoriasis

Sánchez‐Regaña, M.; Dilmé, E.; Puig, L.; Bordas, X.; Carrascosa, J.M.; Ferrán, Marta; Herranz, Pedro; García‐Bustínduy, M.; López-Estebaranz, J.L.; Alsina, M.; Rodríguez, M.A.; Ribera, Miquel; Fernández‐López, Emilia; Moreno, J.C.; Belinchón, Isabel; Vidal, David

doi:10.1016/j.ad.2009.08.001

Cited by 15 publications

(2 citation statements)

References 20 publications

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“… 4 Adverse drug reactions resulting from 1 year of use include malignancies, opportunist infections caused by fungi, tuberculosis, hypertension, among others. 13 , 14 Clinical monitoring of patient, as well as of the way to use the medication, duration of use, dose, and recommendations to patients are all essential ways to reduce and control these events.…”

Section: Discussionmentioning

confidence: 99%

Biological drugs for the treatment of psoriasis in a public health system

et al. 2014

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OBJECTIVE To analyze the access and utilization profile of biological medications for psoriasis provided by the judicial system in Brazil.METHODSThis is a cross-sectional study. We interviewed a total of 203 patients with psoriasis who were on biological medications obtained by the judicial system of the State of Sao Paulo, from 2004 to 2010. Sociodemographics, medical, and political-administrative characteristics were complemented with data obtained from dispensation orders that included biological medications to treat psoriasis and the legal actions involved. The data was analyzed using an electronic data base and shown as simple variable frequencies. The prescriptions contained in the lawsuits were analyzed according to legal provisions.RESULTS A total of 190 lawsuits requesting several biological drugs (adalimumab, efalizumab, etanercept, and infliximab) were analyzed. Patients obtained these medications as a result of injunctions (59.5%) or without having ever demanded biological medication from any health institution (86.2%), i.e., public or private health services. They used the prerogative of free legal aid (72.6%), even though they were represented by private lawyers (91.1%) and treated in private facilities (69.5%). Most of the patients used a biological medication for more than 13 months (66.0%), and some patients were undergoing treatment with this medication when interviewed (44.9%). Approximately one third of the patients discontinued treatment due to worsening of their illness (26.6%), adverse drug reactions (20.5%), lack of efficacy, or because the doctor discontinued this medication (13.8%). None of the analyzed medical prescriptions matched the legal prescribing requirements. Clinical monitoring results showed that 70.3% of the patients had not undergone laboratory examinations (blood work, liver and kidney function tests) for treatment control purposes.CONCLUSIONS The plaintiffs resorted to legal action to get access to biological medications because they were either unaware or had difficulty in accessing them through institutional public health system procedures. Access by means of legal action facilitated long-term use of this type of medication through irregular prescriptions and led to a high rate of adverse drug reactions as well as inappropriate clinical monitoring.

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Section: Discussionmentioning

confidence: 99%

Biological drugs for the treatment of psoriasis in a public health system

et al. 2014

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“…Applying LTBI diagnosis guidelines, latent infection resulted in more psoriasis (50%) than inflammatory bowel disease patients (24.2%), prior to onset of any anti-TNF- α treatment ( P = 0.04) [42]. A recent survey concerning the evaluation of the infectious complications during biological therapy of psoriasis showed a rate of infections of 12.24%, with only one case of pulmonary TB, out of 988 patients [43]. The authors stressed that such a result depend on a strict screening of LTBI, prior to starting the biological treatment.…”

Section: Psoriasis and Tbmentioning

confidence: 99%

Psoriatic Disease and Tuberculosis Nowadays

Balato

Costanzo²,

Ayala³

et al. 2012

Clinical and Developmental Immunology

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Psoriasis is a chronic, relapsing and remitting inflammatory skin and joint disease that has a prevalence of 2-3% in the world's population, whereas of 1–2% in Europe. The traditional concept of psoriasis as the “healthy people's” disease has been recently revised because of ever-increasing reports of associations with various pathological conditions (hypertension, Crohn's disease, type II diabetes mellitus, obesity, dyslipidemia, metabolic syndrome, infectious conditions). Particularly, advances in psoriasis therapies have introduced biologic agents. All the tumor necrosis factor-alpha inhibitors are associated with an increased risk of developing active disease in patients with latent tuberculosis infection, because of TNF-α key role against Mycobacterium tuberculosis. For this reason, exclusion of active tuberculosis and treatment of latent tuberculosis infection are clinical imperatives prior to starting this therapy. Moreover active surveillance for a history of untreated or partially treated tuberculosis or latent form has already been shown to be effective in reducing the number of incident tuberculosis cases.

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