Safety and efficacy of biological therapies in patients with psoriasis with alcoholic cirrhosis: a French retrospective study of 23 cases

Skin and soft tissue infections in biological therapy for psoriasis—A case report and systematic review of the literature

“…The search yielded 1,308 titles, 24 of which met the inclusion criteria: nine papers were based on retrospective data, 7,9,[11][12][13][14][15][16][17] nine were randomized controlled trials, [18][19][20][21][22][23][24][25][26] and six were prospective studies (Tables 1 and 2). [27][28][29][30][31][32] Tumor necrosis factor alpha (TNF-a) inhibitors in SSTIs Fourteen studies 17,19,[20][21][22][23][24][25]28,35,[37][38][39][40] evaluated the three TNF-a inhibitors (infliximab, adalimumab, and etanercept).…”

“…Cellulitis and erysipelas were the most common SSTIs according to 13 papers. 7,9,11,12,13,14,17,20,21,22,23,25,31 One paper reported four cases of necrotizing fasciitis: one with infliximab, one with etanercept, and two with adalimumab. 20 Other biological agents in SSTIs Five papers described the use of secukinumab 9,18,26,28,29 ; four referred to efalizumab, 11,13,22,32 one reported on ustekinumab, 21 and single reports were found on tildrakizumab, 19 ixekizumab, 23 brodalumab, 24 and the interleukin (IL) 23 inhibitor BI 655066.…”

“…It can be concluded, from the overall data presented, that biological treatment is a safe mode of therapy in this aspect. 1/3750 20, a 2/na 19 12/1352 30 13.9/100 18, a 4/5923 20, a 1/23 14 8/994 30 34/173 32, c 1/na…”

A Case of the Safety and Efficacy of Guselkumab in Psoriasis with Alcoholic Liver Cirrhosis

“…concerns of hepatotoxicity, physicians hesitate to prescribe conventional systemic drugs, such as methotrexate and acitretin, to psoriasis patients who have concomitant liver abnormalities. Although biologics have little influence on liver function and are not contraindicated in patients with such abnormalities, few studies specifically address the safety and efficacy of biologics in patients with psoriasis and concomitant liver disease (Table 1) [1][2][3] . A 34-year-old female patient presented at the emergency room of Design Hospital with esophageal varix rupture complicated by alcoholic liver cirrhosis.…”

“…One observational study revealed that IL-12/23 blockers are highly effective in psoriasis patients with alcoholic cirrhosis and do not cause opportunistic infections, mycobacterial infections, and hepatocellular carcinoma 1 . Additionally, persistently high efficacy of biologics was reported despite the ongoing alcohol abuse 1 . Although limited data are available on guselkumab safety in patients with liver insufficiency, the data on safety of IL-12/23 blockers suggest the safety of guselkumab in patients with liver cirrhosis.…”