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.
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.
Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan.
Yoshiyuki
Y
Kusakari
Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan.
Kenshi
K
Yamasaki
Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan.
Toshiya
T
Takahashi
Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan.
Kenichiro
K
Tsuchiyama
Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan.
Ryoko
R
Shimada-Omori
Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan.
Mei
M
Nasu-Tamabuchi
Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan.
Setsuya
S
Aiba
D000068879:Adalimumab / Q000009:adverse effects / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001688:Biological Products / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000150:complications / Q000188:drug therapy*; D006435:Renal Dialysis; D012720:Severity of Illness Index
D000893:Anti-Inflammatory Agents; D001688:Biological Products; D000068879:Adalimumab
adalimumab; biologics; hemodialysis; psoriasis; renal failure