Department of Dermatology, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
Institue of Psoriasis, Tongji University School of Medicine, Shanghai, China
Eur J Dermatol. 2022 May 1;32(3):394-400. doi: 10.1684/ejd.2022.4263.
The burden of hepatitis B virus (HBV) infection in China is high. The safety and efficacy of secukinumab in psoriasis patients with HBV infection have not been fully elucidated.
To investigate the safety and efficacy of secukinumab in psoriasis patients with HBV infection in China.
MATERIALS & METHODS: In this retrospective study, 20 psoriasis patients with HBV infection were identified, all of whom had been treated with secukinumab for ≥24 weeks
Four patients had chronic inactive HBV infection, two patients had occult HBV infection, and the other 14 patients had resolved HBV infection. The HBV-DNA load and HBV markers measured at baseline and Week 24 showed no viral reactivation. Nineteen patients showed normal levels of liver enzymes after 24 weeks of therapy. However, one patient with resolved HBV infection and fatty liver with elevated baseline liver enzymes experienced hepatitis, with negative HBV load at baseline and Week 24. All patients showed a significant improvement in the Psoriasis Area and Severity Index (−13.35 ± 7.41: p < 0.0001), per cent of body surface area (−17.11 ± 17: p = 0.0002), Investigator Global Assessment (−2.55 ± 0.94: p < 0.0001), and Dermatology Life Quality Index (−12.3 ± 7.39; p < 0.0001)
Secukinumab showed good efficacy in psoriasis patients with HBV infection. Chronic, inactive, occult and resolved HBV infection may not increase the risk of hepatitis during secukinumab treatment. Patients with poor baseline liver function, without any intervention during secukinumab treatment, may experience hepatitis. Periodic monitoring with HBV markers, HBV-DNA load, and serological liver function tests is necessary during secukinumab treatment.
中国乙型肝炎病毒(HBV)感染负担沉重。司库奇尤单抗治疗乙型肝炎病毒感染银屑病患者的安全性和疗效尚未完全阐明。
评估司库奇尤单抗在中国乙型肝炎病毒感染银屑病患者中的安全性和疗效。
本回顾性研究共纳入 20 例乙型肝炎病毒感染的银屑病患者,所有患者均接受司库奇尤单抗治疗≥24 周。
4 例患者为慢性非活动性乙型肝炎病毒感染,2 例为隐匿性乙型肝炎病毒感染,14 例患者为乙型肝炎病毒已清除。基线和第 24 周时检测的 HBV-DNA 载量和 HBV 标志物未见病毒再激活。24 周治疗后,19 例患者的肝酶水平正常。然而,1 例乙型肝炎病毒已清除且伴有基线肝酶升高的脂肪肝患者出现肝炎,基线和第 24 周时 HBV 载量均为阴性。所有患者的银屑病面积和严重程度指数(-13.35 ± 7.41:p < 0.0001)、体表面积百分比(-17.11 ± 17:p = 0.0002)、研究者全球评估(-2.55 ± 0.94:p < 0.0001)和皮肤病生活质量指数(-12.3 ± 7.39;p < 0.0001)均有显著改善。
司库奇尤单抗治疗乙型肝炎病毒感染的银屑病患者疗效良好。慢性、非活动性、隐匿性和已清除的乙型肝炎病毒感染不会增加司库奇尤单抗治疗期间发生肝炎的风险。基线肝功能不良且未在司库奇尤单抗治疗期间进行任何干预的患者可能会发生肝炎。在司库奇尤单抗治疗期间,需要定期监测 HBV 标志物、HBV-DNA 载量和血清肝功能检查。