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Abstract
Purpose: Biologic therapy in psoriatic patients with multiple comorbidities is challenging due to worsening of associated diseases and possible side effects of concomitant medications.
Materials and methods: We describe three patients with multiple comorbidities documenting successful treatment of psoriasis with secukinumab following failure of multiple conventional and biologic DMARDs.
Results: The first case is an obese 59-year-old woman (HBV + with latent tuberculosis) with arterial hypertension and 12-year history of breast cancer. The second is a 45-year-old obese man (HCV + with occult HBV infection on therapy with multiple antipsychotics and taking methadone for opioid dependence), while the last is a 39-year-old man with severe obesity, non-alcoholic hepatosteatosis, and NYHA class II heart failure. All three patients had undergone previous conventional (methotrexate, cyclosporine, retinoids, and phototherapy) and multiple biologic treatments (one or more of the following: adalimumab, ustekinumab, etanercept, infliximab originator, and biosimilar) that were discontinued for inefficacy and/or adverse effects. All patients underwent therapy with secukinumab, which was associated with sustained clinical benefits and no clinically relevant safety findings.
Conclusions: The present three cases add further evidence that secukinumab is effective and well tolerated in difficult to treat psoriatic patients with multiple comorbidities, namely HBV, latent TBC infection, and hepatic impairment.
Disclosure statement
No potential conflict of interest was reported by the authors.
Acknowledgements
Health Publishing and Services Srl provided English language assistance; Content Ed Net provided editing assistance; these assistances were funded by Novartis Farma, Italy.