Successful adalimumab treatment of a psoriasis vulgaris patient with hemodialysis for renal failure: A case report and a review of the previous reports on biologic treatments for psoriasis patients with hemodialysis for renal failure
Successful adalimumab treatment of a psoriasis vulgaris patient with hemodialysis for renal failure: A case report and a review of the previous reports on biologic treatments for psoriasis patients with hemodialysis for renal failure
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阿达木单抗成功治疗寻常型银屑病肾衰竭血液透析患者：病例报告及既往银屑病肾衰竭血液透析生物治疗报告回顾
DOI：
10.1111/1346-8138.12901
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发表时间：
2015
期刊：
影响因子：
--
通讯作者：
S. Aiba
中科院分区：
文献类型：
--
作者：
Y. Kusakari;K. Yamasaki;Toshiya Takahashi;K. Tsuchiyama;R. Shimada;Mei Nasu;S. Aiba
生物疗法治疗中重度银屑病的有效性和安全性已得到证实，但有关生物疗法治疗银屑病合并终末期肾功能衰竭血液透析(HD)的报道较少。在这份报告中，我们证明了阿达利玛单抗对HD治疗严重银屑病患者的有效性和安全性。一位46岁的日本男性，有14年的牛皮癣病史，于2009年9月到我们诊所就诊。在接受环孢素治疗的7年历史中，他患上了高血压和肾功能衰竭。通过英夫利昔单抗治疗，他在3个月内牛皮癣面积和严重程度指数(PASI)评分从治疗前的42.3分提高了75%。然而，他的肾功能衰竭逐渐恶化，并在引入英夫利昔单抗一年后开始透析。因为静脉注射时的水合作用。在注射英夫利昔单抗后，他在开始透析后每次英夫利昔单抗治疗时都出现肺水肿。我们改用Ustekinumab治疗，但他的牛皮癣没有改善。然后，我们改用阿达利单抗，并在2个月内实现了PASI-100反应。患者接受了一年多的阿达利马治疗，没有任何不良反应。除了我们的病例，还有5篇文章报道了使用生物制剂治疗的患有肾功能衰竭的银屑病患者。在这些病例中，银屑病皮损被生物制剂改善，并且没有对肾功能产生严重不良反应的报道。因此，生物制剂是HD治疗伴有肾功能衰竭的严重银屑病患者的合理选择。
The efficacy and safety of biologic treatments have been established in patients with moderate to severe psoriasis, but there are few reports on biologic therapy for patients with psoriasis complicated by end‐stage renal failure on hemodialysis (HD). In this report, we demonstrated the efficacy and safety of adalimumab for patients with severe psoriasis on HD. A 46‐year‐old Japanese man with a 14‐year history of psoriasis was referred to our clinic in September 2009. He had developed hypertension and renal failure during a 7‐year history of cyclosporin treatment. With the infliximab treatment, he achieved 75% improvement of the Psoriasis Area and Severity Index (PASI) score within 3 months from the PASI of 42.3 before the treatment. However, his renal failure gradually deteriorated, and HD was initiated at 1 year after the introduction of infliximab. Because of hydration during the i.v. injection of infliximab, he developed pulmonary edema with every infliximab treatment after starting HD. We switched to ustekinumab treatment, but his psoriasis was not improved. Then, we switched to adalimumab and achieved a PASI‐100 response within 2 months. The patient received adalimumab treatment for more than a year without any adverse effects. In addition to our case, five articles reported cases of psoriasis patients with renal failure on HD who were treated with biologics. The psoriatic lesions were improved by biologics in these cases, and no severe adverse effects on the renal function were reported. Thus, biologics are a reasonable treatment option for patients with severe psoriasis with renal failure on HD.