Megna Matteo, Patruno Cataldo, Bongiorno Maria Rita, Gambardella Alessio, Guarneri Claudio, Foti Caterina, Lembo Serena, Loconsole Francesco, Fabbrocini Gabriella
Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy.
Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy.
J Dermatolog Treat. 2022 Aug;33(5):2629-2633. doi: 10.1080/09546634.2022.2062280. Epub 2022 Apr 11.
Some biologics for psoriasis, especially anti-tumor necrosis factor (TNF)-α therapies, may re-activate latent tuberculosis (TBC) infection with consequent morbidity and mortality. However, there is a low reported incidence of conversion to positive TBC status among patients with psoriasis treated with second-generation biologic therapies, particularly anti-interleukin (IL)-17 therapies such as secukinumab.
To evaluate the safety profile of secukinumab in psoriasis patients with latent TBC infection.
Real-life data were collected by retrospective chart review on patients with moderate-to-severe psoriasis who showed positivity for TBC screening at baseline and underwent secukinumab treatment for psoriasis at six Italian centers. Patients received secukinumab 300 mg at week 0/1/2/3/4, then every 4 weeks.
Fifty-nine patients were enrolled; 30.5% also had psoriatic arthritis and other comorbidities were common. At baseline, the mean psoriasis duration was 14.5 years. Ten (17%) patients did not undergo prophylaxis before starting secukinumab. Conversely, isoniazid ± rifampicin or rifampicin alone prophylaxis was administered in 49/59 (83.1%) patients. After a mean treatment duration of 84 weeks, there were no cases of TBC reactivation and no unexpected safety signals.
Secukinumab use over an extended period was safe in psoriasis patients with latent TBC, even in patients who did not receive chemoprophylaxis.
一些用于治疗银屑病的生物制剂，尤其是抗肿瘤坏死因子（TNF）-α疗法，可能会重新激活潜伏性结核（TBC）感染，从而导致发病和死亡。然而，在接受第二代生物疗法治疗的银屑病患者中，尤其是接受诸如司库奇尤单抗等抗白细胞介素（IL）-17疗法的患者中，TBC状态转为阳性的报告发病率较低。
评估司库奇尤单抗在潜伏性TBC感染的银屑病患者中的安全性。
通过回顾性病历审查收集了在六个意大利中心接受治疗的中度至重度银屑病患者的真实数据，这些患者在基线时TBC筛查呈阳性，并接受了司库奇尤单抗治疗银屑病。患者在第0/1/2/3/4周接受300mg司库奇尤单抗，然后每4周一次。
共纳入59例患者；30.5%的患者还患有银屑病关节炎，其他合并症也很常见。基线时，银屑病的平均病程为14.5年。10例（17%）患者在开始使用司库奇尤单抗之前未接受预防性治疗。相反，49/59例（83.1%）患者接受了异烟肼±利福平或单独使用利福平的预防性治疗。在平均治疗84周后，没有TBC重新激活的病例，也没有意外的安全信号。
对于潜伏性TBC的银屑病患者，长期使用司库奇尤单抗是安全的，即使是未接受化学预防的患者。
