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Costa Blasco M, Doyle C, Diong S, Ni Raghallaigh S. Use of biologics for psoriasis in solid organ transplant recipients. Australas J Dermatol 2024; 65:276-279. [PMID: 38623950 DOI: 10.1111/ajd.14292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 02/05/2024] [Accepted: 03/27/2024] [Indexed: 04/17/2024]
Abstract
Biologics have significantly advanced the treatment of inflammatory disorders, including psoriasis. However, their use in immunosuppressed patients, such as those with solid-organ transplants, is less understood. These patients often face dermatological issues, but inflammatory skin diseases are rare due to their immunosuppressive treatments. Our study aims to assess biologics' effectiveness in such immunocompromised patients. We report a case from our institution of a 29-year-old man with a history of psoriasis, who underwent a kidney transplant and later developed erythroderma. He did not respond to traditional treatments and was successfully treated with adalimumab, leading to the discontinuation of MMF. We also reviewed literature in solid organ transplant patients with psoriasis. Our findings, based on 10 articles, indicate a cautious approach to using biologics in this group, with further research needed for efficacy and safety.
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Affiliation(s)
- Marta Costa Blasco
- Department of Dermatology, Beaumont University Hospital, Dublin, Ireland
| | - Claire Doyle
- Department of Dermatology, Beaumont University Hospital, Dublin, Ireland
| | - Sophie Diong
- Department of Dermatology, Beaumont University Hospital, Dublin, Ireland
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2
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Guglielmo A, Pileri A, Toniutto P, Bardazzi F, Potena L, Russo A, Masetti M, Maria Piraccini B, Stinco G. Biologic treatment of psoriasis in solid organ transplant recipients. J Dtsch Dermatol Ges 2024; 22:283-287. [PMID: 38066381 DOI: 10.1111/ddg.15291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 09/28/2023] [Indexed: 12/20/2023]
Affiliation(s)
- Alba Guglielmo
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy
- Institute of Dermatology, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
| | - Alessandro Pileri
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Pierluigi Toniutto
- Internal Medicine, Department of Medical Area, University of Udine, Udine, Italy
| | - Federico Bardazzi
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy
| | - Luciano Potena
- Cardiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Antonio Russo
- Cardiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Marco Masetti
- Cardiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Bianca Maria Piraccini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Giuseppe Stinco
- Institute of Dermatology, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
- Department of Medicine (DAME), University of Udine, Udine, Italy
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3
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Guglielmo A, Pileri A, Toniutto P, Bardazzi F, Potena L, Russo A, Masetti M, Piraccini BM, Stinco G. Biologikatherapie der Psoriasis in organtransplantierten Patienten: Biologic treatment of psoriasis in solid organ transplant recipients. J Dtsch Dermatol Ges 2024; 22:283-287. [PMID: 38361191 DOI: 10.1111/ddg.15291_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 09/28/2023] [Indexed: 02/17/2024]
Affiliation(s)
- Alba Guglielmo
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy
- Institute of Dermatology, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
| | - Alessandro Pileri
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Pierluigi Toniutto
- Internal Medicine, Department of Medical Area, University of Udine, Udine, Italy
| | - Federico Bardazzi
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy
| | - Luciano Potena
- Cardiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Antonio Russo
- Cardiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Marco Masetti
- Cardiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Bianca Maria Piraccini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Giuseppe Stinco
- Institute of Dermatology, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
- Department of Medicine (DAME), University of Udine, Udine, Italy
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Matcaşu I, Haddad N, Barrou B, Conti F, Barete S. Biotherapies for chronic inflammatory dermatosis in organ transplant recipients: 3 case reports and a literature review. Ann Dermatol Venereol 2023; 150:219-222. [PMID: 36739220 DOI: 10.1016/j.annder.2022.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 07/27/2022] [Accepted: 11/08/2022] [Indexed: 02/05/2023]
Affiliation(s)
- I Matcaşu
- Dermatology Unit, Pitié-Salpêtrière Hospital, APHP, Sorbonne Université, Paris, France
| | - N Haddad
- Dermatology Unit, Pitié-Salpêtrière Hospital, APHP, Sorbonne Université, Paris, France
| | - B Barrou
- Kidney Transplantation Unit, Pitié-Salpêtrière Hospital, APHP, Sorbonne Université, Paris, France
| | - F Conti
- Liver Transplantation Unit, Pitié-Salpêtrière Hospital, APHP, Sorbonne Université, Paris, France
| | - S Barete
- Dermatology Unit, Pitié-Salpêtrière Hospital, APHP, Sorbonne Université, Paris, France.
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Jensen NC, Robins J, Snyder AM, Harris R, Ferris LK, Johnson L. Psoriasis in the transplant population. Arch Dermatol Res 2023; 315:1109-1128. [PMID: 36459192 PMCID: PMC11199078 DOI: 10.1007/s00403-022-02487-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 10/25/2022] [Accepted: 11/17/2022] [Indexed: 12/04/2022]
Abstract
Solid organ and stem cell transplants are increasingly common, and dermatologists will more frequently encounter and need to manage common skin diseases, such as psoriasis, in transplant patients. This review explores psoriasis remission and occurrence in recipients of solid organ and stem cell transplants. Hematopoietic and mesenchymal stem cell transplants may show potential for treating psoriasis in patients with leukemia or who have other medical conditions requiring stem cell transplant. The effects of solid organ transplant are less clear, partly due to limitations in the breadth of the literature. De novo psoriasis has been reported in recipients of solid organ transplants, but the reasons for this development have yet to be fully understood. Overall, the literature on this subject is limited to primarily case reports. Feasibility of studies on the subject may be a considerable barrier to further research assessing the use of transplant for treating psoriasis, but there is potential benefit from transplant for psoriasis patients. This subject should receive further exploration to fully understand these benefits.
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Affiliation(s)
| | - Jacob Robins
- Department of Dermatology, University of Utah, 30 North 1900 East, 4A330, Salt Lake City, UT, 84132, USA
| | - Ashley M Snyder
- Department of Dermatology, University of Utah, 30 North 1900 East, 4A330, Salt Lake City, UT, 84132, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | | | - Laura Korb Ferris
- Department of Dermatology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Luke Johnson
- Department of Dermatology, University of Utah, 30 North 1900 East, 4A330, Salt Lake City, UT, 84132, USA.
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Hong JJ, Hadeler EK, Mosca ML, Brownstone ND, Bhutani T, Liao WJ. TNF-alpha inhibitors and ustekinumab for the treatment of psoriasis: therapeutic utility in the era of IL-17 and IL-23 inhibitors. JOURNAL OF PSORIASIS AND PSORIATIC ARTHRITIS 2022; 7:79-92. [PMID: 35757187 PMCID: PMC9229820 DOI: 10.1177/24755303211047479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Psoriasis is a chronic inflammatory condition for which eleven FDA-approved biologic therapies are approved. Over the past decade, studies have documented the higher efficacy of IL-17 and IL-23 inhibitors for the treatment of psoriasis compared to the TNF-alpha inhibitors and ustekinumab, an IL-12/23 inhibitor. Despite this, there remains an important role for the use of TNF-alpha inhibitors and ustekinumab in the treatment of psoriasis. Here, we review how considerations of infection and malignancy risk, patient demographics, treatment resistance, and co-morbidities may make certain TNF-alpha inhibitors or ustekinumab an excellent choice for therapy in particular patient subgroups.
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Affiliation(s)
- Julie J Hong
- University of California San Francisco, Department of Dermatology, Psoriasis and Skin Treatment Center
| | - Edward K Hadeler
- University of California San Francisco, Department of Dermatology, Psoriasis and Skin Treatment Center
| | - Megan L Mosca
- University of California San Francisco, Department of Dermatology, Psoriasis and Skin Treatment Center
| | - Nicholas D Brownstone
- University of California San Francisco, Department of Dermatology, Psoriasis and Skin Treatment Center
| | - Tina Bhutani
- University of California San Francisco, Department of Dermatology, Psoriasis and Skin Treatment Center
| | - Wilson J Liao
- University of California San Francisco, Department of Dermatology, Psoriasis and Skin Treatment Center
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Meyer F, Weil-Verhoeven D, Prati C, Wendling D, Verhoeven F. Safety of biologic treatments in solid organ transplant recipients: A systematic review. Semin Arthritis Rheum 2021; 51:1263-1273. [PMID: 34507811 DOI: 10.1016/j.semarthrit.2021.08.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 07/29/2021] [Accepted: 08/24/2021] [Indexed: 01/15/2023]
Abstract
BACKGROUND The development of biological treatments has transformed the management of a broad spectrum of autoimmune/inflammatory diseases. However, little is known about their use in solid-organ transplant recipients. This study aimed to evaluate complications occurring with biologic treatments in solid-organ transplant recipients. METHODS A systematic review of the literature was performed in the Medline, Embase and Cochrane databases, up to 01/10/2020, to identify published case reports or series reporting the use of biologic treatments in solid organ transplant recipients with chronic inflammatory diseases. We collected data on patient characteristics and reported complications. RESULTS In total, 57 articles were included, totalling 187 patients (141 liver, 42 kidney, 3 heart, and 1 liver-kidney transplant recipients). Inflammatory bowel diseases represented the most common indication for biologic treatment initiation (80.7%), followed by rheumatic diseases (7.5%), hereditary periodic fever syndromes (5.9%) and psoriasis (4.8%). Anti-TNFα were mainly used (77.5%; mainly monoclonal antibodies (70%) compared to soluble receptor etanercept (7.5%)), followed by the anti-α4β7 integrin, vedolizumab (27.3%) and the anti-IL-1R, anakinra (6.9%). Median treatment duration was 12 months. Infections occurred in 54 patients (28.9%) through 88 recorded events. No therapeutic or demographic factors were associated with occurrence of infection. Sixteen patients (8.6%) developed malignancies, and acute graft rejections occurred in 5 patients (2.7%). Among the 187 patients, 9 deaths were reported (4.8%). CONCLUSIONS This review assembles the largest number of published reports regarding the use of biological treatments in solid organ transplant recipients, providing data about their safety. Further comparative studies are needed to assess the safety of biological treatments in transplanted patients.
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Affiliation(s)
- Frédéric Meyer
- Department of Rheumatology, CHRU Besançon, 3 boulevard Fleming, 25000 Besançon, France
| | - Delphine Weil-Verhoeven
- Department of Hepatology, CHRU Besançon, 3 boulevard Fleming, 25000 Besançon, France; EA 4266; "EPILAB", FHU increase, Université Bourgogne - Franche Comté, UFR Santé, 19 rue Ambroise Paré, bâtiment S 25030 Besançon cedex, France
| | - Clément Prati
- Department of Rheumatology, CHRU Besançon, 3 boulevard Fleming, 25000 Besançon, France; EA 4267: "PEPITE", FHU increase, Université Bourgogne - Franche Comté, UFR Santé, 19 rue Ambroise Paré, bâtiment S 25030 Besançon cedex, France
| | - Daniel Wendling
- Department of Rheumatology, CHRU Besançon, 3 boulevard Fleming, 25000 Besançon, France; EA 4266; "EPILAB", FHU increase, Université Bourgogne - Franche Comté, UFR Santé, 19 rue Ambroise Paré, bâtiment S 25030 Besançon cedex, France
| | - Frank Verhoeven
- Department of Rheumatology, CHRU Besançon, 3 boulevard Fleming, 25000 Besançon, France; EA 4267: "PEPITE", FHU increase, Université Bourgogne - Franche Comté, UFR Santé, 19 rue Ambroise Paré, bâtiment S 25030 Besançon cedex, France.
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