Safety and effectiveness of conventional systemic therapy and biological drugs in patients with moderate to severe psoriasis and HIV infection: a retrospective multicenter study.
Por:
Montes-Torres A, Aparicio G, Rivera R, Vilarrasa E, Marcellán M, Notario J, Soria C, Belinchón I, de la Cueva P, Ferrán M, Carrascosa JM, Gómez FJ, Salgado L, Velasco M, Descalzo MÁ, García-Doval I and Daudén E
Publicada:
1 ago 2019
Ahead of Print:
28 nov 2018
Resumen:
Background: The management of HIV-positive patients with psoriasis is controversial and limited to individual cases or short series of patients. Objectives: To evaluate the safety and effectiveness of conventional and biologic immunosuppressive drugs in the treatment of patients with psoriasis and concomitant HIV infection. Methods: A retrospective multicenter study was conducted. The study included data from 2008 to 2016. Inclusion criteria were: HIV adult patients with moderate-to-severe psoriasis, HIV viral load determinations at baseline and at least after 6 months of treatment, and systemic immunosuppressive treatment for at least 6 months. A descriptive analysis was performed. Results: Twenty-three patients with plaque-type psoriasis and HIV infection (five with AIDS) were included. Median follow-up time was 3.2 years. The main drugs used were etanercept, methotrexate, and ustekinumab. In most cases, viral load and CD4 cell count not only remained stable but also improved throughout the follow-up. Six patients presented severe adverse events during the follow-up, four of them in the AIDS stage. At the end of the follow-up period, 76.5% of the patients had achieved a PASI 75. Conclusion: Biologic drugs, both anti-TNF alpha agents and ustekinumab, seem to have an acceptable safety profile and high effectiveness in HIV-positive patients.
Filiaciones:
Montes-Torres A:
a Department of Dermatology , Hospital Universitario de La Princesa , Madrid , Spain
b Department of Dermatology , Hospital Central de la Defensa Gómez Ulla , Madrid , Spain
Aparicio G:
c Department of Dermatology , Hospital Universitario Vall d'Hebron , Barcelona , Spain
Rivera R:
d Department of Dermatology , Hospital Universitario Doce de Octubre , Madrid , Spain
Vilarrasa E:
e Department of Dermatology , Hospital Universitario de la Santa Creu i Sant Pau , Barcelona , Spain
Marcellán M:
f Department of Dermatology , Hospital Universitario Marqués de Valdecilla , Santander , Spain
Notario J:
g Department of Dermatology , Hospital Universitario de Bellvitge , L'Hospitalet de Llobregat , Spain
Soria C:
h Department of Dermatology , Hospital General Universitario Reina Sofía , Murcia , Spain
:
i Department of Dermatology , Hospital General Universitario de Alicante , Alicante , Spain
de la Cueva P:
j Department of Dermatology , Hospital Universitario Infanta Leonor , Madrid , Spain
Ferrán M:
k Department of Dermatology , Hospital del Mar, Parc de Salut Mar , Barcelona , Spain
Carrascosa JM:
l Department of Dermatology , Hospital Universitario Germans Trias i Pujol , Badalona , Spain
Gómez FJ:
m Department of Dermatology , Hospital Universitario Reina Sofía , Córdoba , Spain
Salgado L:
n Department of Dermatology , Complejo Hospitalario Universitario de Pontevedra , Pontevedra , Spain
Velasco M:
o Department of Dermatology , Hospital Universitario Arnau de Vilanova , Valencia , Spain
Descalzo MÁ:
p Research Unit. Fundación Piel Sana AEDV , Madrid , Spain
García-Doval I:
p Research Unit. Fundación Piel Sana AEDV , Madrid , Spain
q Department of Dermatology , Complejo Hospitalario Universitario de Vigo , Vigo , Spain
Daudén E:
a Department of Dermatology , Hospital Universitario de La Princesa , Madrid , Spain
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