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Safety and efficacy of HCV eradication during etanercept treatment for severe psoriasis
Author(s) -
Pescitelli Leonardo,
Lazzeri Linda,
Tripo Lara,
Ricceri Federica,
Di Cesare Antonella,
Prignano Francesca
Publication year - 2018
Publication title -
dermatologic therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.595
H-Index - 68
eISSN - 1529-8019
pISSN - 1396-0296
DOI - 10.1111/dth.12614
Subject(s) - medicine , sofosbuvir , etanercept , psoriasis , hepatitis c , dermatology , fibrosis , chronic hepatitis , immunology , tumor necrosis factor alpha , ribavirin , virus
Treatment of severe psoriasis in HCV positive patients is challenging, because several psoriasis medications have a toxic effect on the liver, and interferon alpha, used to treat hepatitis, can induce worsening of psoriatic lesions. TNF‐alpha inhibitors seem to be a safe and effective option in HCV positive psoriatic patients, but there are concerns about long‐term safety, impact on liver fibrosis progression and risk of immune‐mediated liver injury. With regard to HCV treatment, new direct‐acting antiviral therapies (DAA) seem to be extremely effective, with minimal side effects, but little is known about possible interactions with other medications, particularly with biologics. We report the case of a psoriatic patient, in treatment with Etanercept, who needed to undergo HCV eradication with Daclastavir and Sofosbuvir because of worsening liver fibrosis due to chronic hepatitis C. The present treatment produced excellent results in terms of HCV eradication and control of psoriatic lesions, without side effects.