Fatal Influenza A(H1N1) Respiratory Tract Infection in a Patient Having Psoriasis Treated With Infliximab

Kling, Maxwell C.; Larian, Amir; Scordi-Bello, Irini; Emer, Jason; Lebwohl, Mark

doi:10.1001/archdermatol.2010.96

Cited by 20 publications

(7 citation statements)

References 27 publications

(50 reference statements)

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“…Considering the absence of hospital admissions and particularly serious symptoms, and the limited number of patients who changed therapy during ILI, the impact of the pandemic can certainly be considered as light among the sample considered by us; the rarity in the literature of reports of the effect of influenza viruses on patients being treated with biotechnological drugs during the pandemic appears in line with this consideration (20,21). Discussion in the literature of proof in laboratory animals of the responsibility of TNF-α as a mediator for pulmonary inflammation during viral pneumonia, and the positive effects it has the treatment with anti-TNF on symptoms and anatomopathological lesions in the same animals seems important (22,23).…”

Section: N Discussionmentioning

confidence: 84%

Incidence of influenza-like illness into a cohort of patients affected by chronic inflammatory rheumatism and treated with biological agents

Bello¹,

Serafino²,

Bonali³

et al. 2012

Reumatismo

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This study aimed to evaluate the incidence of influenza-like illness (ILI), from October 2009 to May 2010, in a group of patients suffering from chronic inflammatory rheumatism and treated with biological therapies. At the end of 2009-2010 influenza season, 159 patients under biological therapies answered to a questionnaire distributed 8 months before and were deeply interviewed. The group included 69 men and 90 women (mean age 47.6); forty-nine suffering from rheumatoid arthritis, 61 with psoriatic arthritis, 32 with ankylosing spondylitis and 17 with other spondyloarthritis; 146 patients were treated with anti-TNF-α, 7 with rituximab and 6 with abatacept; 128 patients assumed DMARDs and 72 patients assumed low dose of steroids. A case of ILI was identified by anamnestic findings and according to the case definitions commonly used in Europe. Seventeen percent of the considered population reported at least one episode of ILI during the monitoring period; none of the patients during the acute influenza attack suffered particularly severe symptoms and no one was hospitalized due to complications. Despite the diversity among the considered subgroups, the statistical analysis did not show any significant difference when incidence of ILI was considered for different disease, different biological agent and different association therapy. None of the examined variables resulted statistically significant concerning the relative risk evaluation. The incidence of ILI into a cohort of 159 patients treated with biological agents during the influenza season 2009-2010 resulted higher than the value reported in a wide sample of Italian population in the same period. However, the pandemic impact was not heavy among the studied patients, considering that no important complications or hospitalizations have been reported.

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Section: N Discussionmentioning

confidence: 84%

Incidence of influenza-like illness into a cohort of patients affected by chronic inflammatory rheumatism and treated with biological agents

Bello¹,

Serafino²,

Bonali³

et al. 2012

Reumatismo

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“…Infection by the H1N1 virus may be severe and even fatal in immunocompromised patients. Kling et al reported the case of a woman with obesity and psoriasis who died from the complications of infection by H1N1 1 week after her first infusion with infliximab (29). The clinical course of 10 immunocompromised patients, 5 of whom were being treated with corticosteroids, was characterized by a clinical picture similar to that of nonimmunocompromised patients, but with a prolonged course and higher mortality (30).…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of vaccination against pandemic 2009 influenza A (H1N1) virus among patients with rheumatic diseases

et al. 2011

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Objective. To assess the efficacy and safety of vaccination against pandemic H1N1 virus in patients with rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), psoriatic arthritis (PsA), and ankylosing spondylitis (AS) compared with healthy controls. Methods. The study population comprised 41 RA patients, 21 SLE patients, 17 PsA patients, 15 AS patients, and 25 healthy controls. All were vaccinated using the Novartis MF59-adjuvanted H1N1v monovalent influenza vaccine. The immunogenicity of the vaccine was assessed on day 1 and again 4 weeks later by hemagglutination inhibition assay. Geometric mean titers and seroconversion rates were calculated for each group. The safety of the vaccine was evaluated using the 28-joint Disease Activity Score (DAS28) for RA and PsA, the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI), and the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Results. The proportion of baseline protective levels of antibodies against H1N1 was similar in all but the AS group, in which it was lower. The geometric mean titers increased significantly in all 5 groups. A substantial proportion of patients and controls responded to the vaccine. The healthy controls demonstrated a better response than each of the other groups: 84% versus 56% for RA, 67% for SLE, 59% for PsA, and 53% for AS. Multivariate logistic regression analysis identified RA and PsA as parameters of significantly lower response. The DAS28, BASDAI, and SLEDAI remained unchanged after vaccination. Conclusion. Vaccination against pandemic H1N1 using an adjuvanted H1N1v monovalent influenza is safe and induced an appropriate response in patients with RA, SLE, PsA, and AS.

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“…2 Furthermore, Kling et al described a patient with psoriasis taking immunosuppressive drugs resulted positive for influenza A (H1N1) who, after an initially efalizumab therapy, was switched to infliximab for a severe psoriatic flare and died after her first infusion. 3 Based on previous cases of death or increased risk of infection from viral diseases in immunosuppressive patients, we would like to stress the importance of a therapeutic reassessment of all psoriatic patients, chronically treated with immunosuppressive drugs, that weaken the immune system and make them more susceptible to opportunistic infections. Cyclosporine (CsA), methotrexate (MTX) and anti-TNF-alpha are among the first-choice therapies for psoriatic patients with PASI>10, often prescribed to healthy young patients free from cardiovascular diseases and comorbidities.…”

mentioning

confidence: 99%

COVID‐19 and psoriasis: Is it time to limit treatment with immunosuppressants? A call for action

Conforti

Giuffrida

Dianzani

et al. 2020

Dermatologic Therapy

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Fatal Influenza A(H1N1) Respiratory Tract Infection in a Patient Having Psoriasis Treated With Infliximab

Cited by 20 publications

References 27 publications

Incidence of influenza-like illness into a cohort of patients affected by chronic inflammatory rheumatism and treated with biological agents

Incidence of influenza-like illness into a cohort of patients affected by chronic inflammatory rheumatism and treated with biological agents

Efficacy and safety of vaccination against pandemic 2009 influenza A (H1N1) virus among patients with rheumatic diseases

COVID‐19 and psoriasis: Is it time to limit treatment with immunosuppressants? A call for action

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