bms-790052 and Psoriasis

Until recently, clinicians caring for patients with psoriasis who were infected with hepatitis C virus (HCV) were concerned that treating one condition could exacerbate the other. We evaluated the outcome of treatment with direct-acting antiviral agents (DAAs) on patients with psoriasis having chronic hepatitis C (CHC) infection.. This was an observational prospective cross-sectional study. It included CHC-naive patients with plaque psoriasis. All patients received sofosbuvir plus daclatasvir once daily for 12 weeks for treatment of CHC. Psoriasis area severity index (PASI) scores and the dermatology quality-of-life index were evaluated at the start of treatment with DAAs and then at 12 and 24 weeks after the end of HCV treatment. The primary end point was sustained virological response 12 weeks after treatment (SVR12).. A total of 34 CHC-naive patients were enrolled in this study. Most of them were of male sex (76.5%), and most of them had severe psoriasis, as the mean PASI score was 32. The primary and secondary end points (SVR12 and SVR24) for our patients were 100%. Regarding PASI and dermatology quality-of-life index scores, there was a highly significant difference before start of treatment and after treatment at 12 and 24 weeks. The most common adverse events are fatigue and headache.. Sofosbuvir plus daclatasvir is effective in the eradication of HCV and improvement of symptoms in patients with psoriasis having CHC infection. Future large series studies are needed to evaluate this promising effect of DAAs.

Topics: Adolescent; Adult; Aged; Antiviral Agents; Carbamates; Cross-Sectional Studies; Dose-Response Relationship, Drug; Drug Therapy, Combination; Female; Follow-Up Studies; Hepacivirus; Hepatitis C, Chronic; Humans; Imidazoles; Male; Middle Aged; Prospective Studies; Psoriasis; Pyrrolidines; Quality of Life; Sofosbuvir; Treatment Outcome; Valine; Viral Load; Young Adult

Topics: Aged; Antiviral Agents; Carbamates; Dermatologic Agents; Hepacivirus; Hepatitis C, Chronic; Humans; Imidazoles; Isoquinolines; Male; Psoriasis; Pyrrolidines; Remission Induction; RNA, Viral; Severity of Illness Index; Sulfonamides; Ustekinumab; Valine

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.

Topics: Aged; Antiviral Agents; Carbamates; Etanercept; Hepacivirus; Hepatitis C, Chronic; Humans; Imidazoles; Immunosuppressive Agents; Male; Psoriasis; Pyrrolidines; Severity of Illness Index; Sofosbuvir; Treatment Outcome; Tumor Necrosis Factor-alpha; Valine

Topics: Adult; Aged; Antiviral Agents; Carbamates; Drug Therapy, Combination; Female; Hepatitis C, Chronic; Humans; Imidazoles; Male; Middle Aged; Psoriasis; Pyrrolidines; Ribavirin; Simeprevir; Sofosbuvir; Symptom Flare Up; Valine

Sofosbuvir (SOF) and daclatasvir (DCV) have revolutionized the treatment of hepatitis C virus and now represent the preferred therapy for this disease. Limited data are available on the dermatological side effects resulting from co-administration of SOF and DCV.. We report a case of an erythema multiforme drug eruption associated with erythrodermic psoriasis induced by SOF and DCV. After ceasing treatment, the skin condition significantly improved.. We should pay attention to adverse skin reactions resulting from SOF and DCV, especially if the patient has a pre-existing dermatosis.

Topics: Carbamates; Drug Eruptions; Erythema Multiforme; Humans; Imidazoles; Male; Middle Aged; Psoriasis; Pyrrolidines; Sofosbuvir; Valine