title: Tumor necrosis factor-alpha inhibitors for the treatment of psoriasis patients with liver cirrhosis: A report of four cases with a literature review.
abstract: Patients with psoriasis are at an increased risk of developing liver disease due to various factors. The existing data regarding the treatment of psoriasis patients with associated liver cirrhosis is limited. We report four patients of psoriasis with liver cirrhosis who were treated with TNF-alpha inhibitors for a mean duration of 35.4 months. Two patients were treated with etanercept, one with adalimumab and one was treated with both infliximab and etanercept. Three patients tolerated the treatment well without any deterioration of liver disease whereas one died of progressive liver disease. Although large-scale, controlled studies are needed, this case series provides insights regarding the long-term safety of TNF-alpha inhibitors in patients with psoriasis and liver cirrhosis.
authors.affiliation: Department of Dermatology, Marmara University School of Medicine, Istanbul, Turkey.
authors.forename: Tulin
authors.initials: T
authors.lastname: Ergun
authors.affiliation: Department of Dermatology, Marmara University School of Medicine, Istanbul, Turkey.
authors.forename: Dilek
authors.initials: D
authors.lastname: Seckin-Gencosmanoglu
authors.affiliation: Department of Dermatology, Marmara University School of Medicine, Istanbul, Turkey.
authors.forename: Andac
authors.initials: A
authors.lastname: Salman
authors.affiliation: Department of Dermatology, Marmara University School of Medicine, Istanbul, Turkey.
authors.forename: Zuleyha
authors.initials: Z
authors.lastname: Ozgen
authors.affiliation: Department of Dermatology, Marmara University School of Medicine, Istanbul, Turkey.
authors.forename: Esra Sarac
authors.initials: ES
authors.lastname: Ocak
authors.affiliation: Department of Gastroenterology, Academic Hospital, Istanbul, Turkey.
authors.forename: Erol
authors.initials: E
authors.lastname: Avsar
authors.affiliation: Department of Gastroenterology, Marmara University School of Medicine, Istanbul, Turkey.
authors.forename: Nese
authors.initials: N
authors.lastname: Imeryuz
mesh_terms: D000068879:Adalimumab / Q000008:administration & dosage; D003879:Dermatologic Agents / Q000008:administration & dosage; D000068800:Etanercept / Q000008:administration & dosage; D005260:Female; D006801:Humans; D000069285:Infliximab / Q000008:administration & dosage; D008103:Liver Cirrhosis / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy*; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
chemical_list: D003879:Dermatologic Agents; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D000068879:Adalimumab; D000068800:Etanercept