Managing Psoriasis in Patients with HBV or HCV Infection: Practical Considerations

Piaserico, Stefano; Messina, Francesco; Russo, Francesco Paolo

doi:10.1007/s40257-019-00457-3

Cited by 35 publications

(71 citation statements)

References 142 publications

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“…In contrast, some reports considering treatment options for patients with HBV and HCV infection indicated that the use of cyclosporine was associated with a moderate (1-10%) risk of HBV reactivation during psoriasis treatment, including the need for concomitant anti-HBV prophylactic therapy and the checking of HBV DNA levels every three months [14].…”

Section: Hepatitis B Virusmentioning

confidence: 98%

“…Hepatitis C [15][16][17] Influenza virus infection [28] Rotavirus infection [29,30] Human Immunodeficiency Virus infection [26,33,34] Coronavirus infection [39][40][41][42][43] Hepatitis B [10][11][12][13][14] Hepatitis D [12,20] Herpes simplex infection [26,27] Herpes Zoster Virus infection [35,36] Hepatitis E [21] Cytomegalovirus infection [19,20,22] Human Papilloma Virus infection [29,30] Human Herpesvirus-8 (Kaposi Sarcoma virus) infection [42,43] The possible beneficial effect of cyclosporine on the course of COVID-19 seems very probable. Thus, it is not justified to suggest that patients with autoimmune diseases should discontinue cyclosporine therapy solely because of the COVID-19 pandemic.…”

Section: Possible Negative Effect Of Cyclosporine On Disease Coursementioning

confidence: 99%

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The Antiviral Properties of Cyclosporine. Focus on Coronavirus, Hepatitis C Virus, Influenza Virus, and Human Immunodeficiency Virus Infections

Głowacka

Rudnicka

Warszawik-Hendzel

et al. 2020

Biology

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This review updates current knowledge regarding the risk of viral infections, including COVID-19, in patients treated with cyclosporine. We also shortly refer to bacterial infections and parasitic infestations in patients treated with cyclosporin. Cyclosporine is an immunosuppressive drug, which is widely used in medicine, including in the treatment of autoimmune skin diseases in dermatology, rheumatology, ophthalmology and nephrology, and in organ transplantation. A usual concern associated with immunosuppressive treatment is the potential risk of infections. Interestingly, several data indicate a relatively low risk of infections, especially viral infections, in patients receiving cyclosporine. It was shown that cyclosporine exerts an inhibitory effect on the replication of some viruses, or may have a potentially beneficial effect on the disease course in infections. These include hepatitis C, influenza virus, rotavirus, human immunodeficiency virus and coronavirus infections. Available data indicate that cyclosporine may have a beneficial effect on COVID-19, which is caused by the coronavirus SARS-COV2.

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Section: Hepatitis B Virusmentioning

confidence: 98%

Section: Possible Negative Effect Of Cyclosporine On Disease Coursementioning

confidence: 99%

The Antiviral Properties of Cyclosporine. Focus on Coronavirus, Hepatitis C Virus, Influenza Virus, and Human Immunodeficiency Virus Infections

Głowacka

Rudnicka

Warszawik-Hendzel

et al. 2020

Biology

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“…11,13,27 Monitoring of liver enzymes and HBV DNA every 3 months is mandatory during treatment and for 6 to 12 months after drug discontinuation since HBV reactivation typically occurred during and after immune reconstitution. 11,13,27 Data relating to the use of biologic agents in HBV patients with psoriasis are increasingly available, and most of the available data are specific to anti-TNFs (in more than 200 patients with psoriasis). 5 Similar to other conventional therapies for psoriasis, HBsAg+ patients are at higher risk than HBsAg−/HBcAb+ patients for HBV reactivation.…”

Section: Discussionmentioning

confidence: 99%

Impact of long‐term systemic treatment for psoriasis on liver disease in psoriasis patients with coexisting hepatitis B virus infection

Chularojanamontri

Nimanong

Wongpraparut

et al. 2020

Dermatologic Therapy

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Continuously updated information is helpful for evaluating the safety of long-term systemic drug use in psoriasis patients with concomitant hepatitis B virus (HBV) infection. To investigate the impact of long-term systemic treatment for psoriasis on liver disease in psoriasis patients with HBV infection. Data of patients during 10-year period were recorded and analyzed. Sixty-six patients (46 males and 20 females) with a mean age of 58.5 ± 13.1 years were recruited. Our study estimated that the 5-year cumulative risks of developing cirrhosis and HCC were 30% and 5%, respectively, in patients receiving systemic treatments for psoriasis. Risks of cirrhosis and HCC were not significantly different between systemic and topical treatment groups. Thirty patients were prescribed systemic treatments (acitretin, methotrexate, ciclosporin, and anti-tumor necrosis factors). Three HBsAg+ patients developed viral reactivation (two patients with methotrexate and one patient with ciclosporin). The effects of systemic treatments for psoriasis on liver outcome in patients with coexisting HBV infection are needed to be determined. HBsAg+ patients are more likely to develop viral reactivation during systemic treatment for psoriasis than HBsAg− patients. Monitoring of liver enzymes and HBV DNA every 3 months is recommended during treatment and for 6 to 12 months after drug discontinuation.

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“…44,45 There is also limited data supporting the use of the IL12/23 inhibitor ustekinumab, and the IL17 inhibitors secukinumab and ixekizumab. 46,47 Results from the first active comparator (ACCEPT) study of psoriasis biologic agents comparing ustekinumab and the TNF antagonist etanercept demonstrated that it is more appropriate to use etanercept rather than ustekinumab in psoriasis patients with hepatitis C infection. 48 We note a lack of data with the other IL23/p19 inhibitors: guselkumab, risankizumab and tildrakizumab; and the IL17 receptor blocker: brodalumab, and with the synthetic drug apremilast, in these patients.…”

Section: Chronic Infectionsmentioning

confidence: 99%

“…Data from two large clinical trials also show that the risk of hepatitis B infection is similar with or without apremilast treatment. 46,53 The only reports from reactivation of hepatitis B with cyclosporin are from severe immunosuppressed patients. 54 Reactivation of hepatitis B occurred in 39% of HBsAg+ patients treated with TFN-a-blockers for autoimmune diseases but not in HBsAg-/anti-HBc+ patients.…”

Section: Chronic Infectionsmentioning

confidence: 99%

Practical recommendations for systemic treatment in psoriasis in case of coexisting inflammatory, neurologic, infectious or malignant disorders (BETA‐PSO: Belgian Evidence‐based Treatment Advice in Psoriasis; part 2)

Lambert

Segaert²,

Ghislain

et al. 2020

Acad Dermatol Venereol

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Background Psoriasis patients carry an increased risk for associated comorbidities. Dermatologists have to be aware of the effects of systemic treatments not only on psoriasis but also on co‐occurring diseases. In case of other coexisting inflammatory diseases, the right psoriasis treatment may improve both disorders. For infectious and malignant disorders, some treatments have to be avoided as they may be harmful. Objective The primary objective of this project was to collect evidence for the creation of practice guidelines for systemic treatment of psoriasis (BETA‐PSO: Belgian Evidence‐based Treatment Advice in Psoriasis). Methods Evidence‐based recommendations were formulated using a quasi‐Delphi methodology after a systematic search of the literature and a consensus procedure involving eight psoriasis experts. Results Recommendations are given on the use of systemic treatment in psoriatic arthritis, inflammatory bowel disease, demyelinating disorders, hepatitis B and C, HIV and cancer. Conclusion This expert opinion is a practical guide for dermatologists when handling psoriasis patients with these specific conditions.

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Managing Psoriasis in Patients with HBV or HCV Infection: Practical Considerations

Cited by 35 publications

References 142 publications

The Antiviral Properties of Cyclosporine. Focus on Coronavirus, Hepatitis C Virus, Influenza Virus, and Human Immunodeficiency Virus Infections

The Antiviral Properties of Cyclosporine. Focus on Coronavirus, Hepatitis C Virus, Influenza Virus, and Human Immunodeficiency Virus Infections

Impact of long‐term systemic treatment for psoriasis on liver disease in psoriasis patients with coexisting hepatitis B virus infection

Practical recommendations for systemic treatment in psoriasis in case of coexisting inflammatory, neurologic, infectious or malignant disorders (BETA‐PSO: Belgian Evidence‐based Treatment Advice in Psoriasis; part 2)

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