eISSN: 2299-0046
ISSN: 1642-395X
Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii
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3/2020
vol. 37
 
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abstract:
Original paper

Long-term safety and efficacy of adalimumab in psoriasis: a multicentric study focused on infections (connecting study)

Alessandra Narcisi
1, 2
,
Nicoletta Bernardini
3
,
Diego Orsini
4
,
Magda D’Agostino
5
,
Catia De Felice
6
,
Alessandro Di Stefani
5
,
Valentina Carboni
7
,
Antonio Costanzo
1, 2
,
Claudio Mastroianni
8

1.
Humanitas Clinical and Research Center, Skin Pathology Lab, Rozzano-Milan, Italy
2.
Dermatology Unit, Department of Biomedical Sciences, Humanitas University, Rozzano-Milan, Italy
3.
Dermatology Unit “Daniele Innocenzi”, University of Rome “Sapienza”, I Faculty of Medicine and Surgery, Polo Pontino,Terracina (LT), Italy
4.
IFO San Gallicano Institute (IRCCS), Infectious Dermatology and Allergology Unit, Rome, Italy
5.
Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
6.
IFO San Gallicano Institute (IRCCS), Psoriasis Unit, Rome, Italy
7.
Dermatology Unit ASL Rm-H, Frascati (RM), Italy
8.
Infectious Disease Unit, Department of Public Health and Infectious Diseases, University of Rome “Sapienza”, Policlinico Umberto I Hospital of Rome, Italy
Adv Dermatol Allergol 2020; XXXVII (3): 428-434
Online publish date: 2020/07/16
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Introduction
This Italian multicenter retrospective study evaluated safety and efficacy of the anti-TNF drug, adalimumab, in a cohort of patients affected by tuberculosis (TB), hepatitis B virus (HBV), hepatitis C virus (HCV) or human immunodeficiency virus (HIV). Psoriasis is an autoimmune disease affecting around 3% of the Italian population and associated with several comorbidities, including arthritis, cardio-metabolic diseases and depression. In its moderate-to-severe form, psoriasis profoundly impairs quality of life of patients.

Aim
Therefore, these patients deserve systemic treatments including conventional DMARDS (disease modifying anti-rheumatic drugs) and biologics. Management of moderate and severe psoriasis patients affected by relevant infections such as TB, HBV, HCV and HIV may be difficult because of the toxicity of the conventional systemic treatment.

Material and methods
The CONNECTING study analysed 28 moderate to severe psoriasis patients infected by TB, HBV, HCV and HIV who were treated with adalimumab for up to 96 weeks together with respective prophylactic treatment.

Results
We observed a rapid decrease in PASI (psoriasis area severity index) reaching a 75% improvement in 91% of patients. Some of these patients (n = 9) were also affected by arthritic comorbidity. The patients experienced a rapid decrease in pain, measured by pain VAS (visual analogic scale) that reached 0 in all of them. Monitoring of the respective infection did not show any worsening or reactivation of infection or any severe adverse events during the entire observation period.

Conclusions
Adalimumab is effective and safe in patients affected by these important infections.

keywords:

psoriasis, infection, biological drugs, adalimumab, efficacy, safety

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