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Case Report
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| Anti-IL-12/IL-23 treatment for a psoriatic patient with heart failure | ||||||
| Auriemma Matteo1, Caponio Chiara2, Ruggiero Carlo3, Giuliani Federica3, Amerio Paolo4 | ||||||
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1(MD, PhD student), Department of Experimental and Clinical Sciences, Dermatologic Clinic, G. d’Annunzio University, Chieti, Italy.
2(MD, resident), Department of Medicine and Aging Science (DMSI), Dermatologic Clinic, G. d’Annunzio University, Chieti, Italy. 3(MD, fellow), Department of Medicine and Aging Science (DMSI), Dermatologic Clinic, G. d’Annunzio University, Chieti, Italy. 4(PhD, MD, director), Department of Medicine and Aging Science (DMSI), Dermatologic Clinic, G. d’Annunzio University, Chieti, Italy. | ||||||
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| How to cite this article: |
| Matteo A, Chiara C, Carlo R, Federica G, Paolo A. Anti-IL-12/IL-23 treatment for a psoriatic patient with heart failure. International Journal of Case Reports and Images 2013;4(5):266–269. |
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Abstract
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Introduction:
Psoriasis is an inflammatory disorder characterized by a deregulation in the Th1/Th17/Treg cells count and function. A plethora of new drugs called "biologicals" have been developed. Beside TNF-α blockers, new drugs interfering with the IL-23 axis have been introduced.
Case Report: We present case of: a 59-year-old high-need psoriatic patient hospitalized for acute heart failure. Physicians decided to withdraw anti-TNF-α therapy because of NYHA class III and the need of cardio-surgery. Surgery was delayed for his general conditions. The patient was referred to our department to establish a new therapy. A treatment with anti-IL-12/IL-23p40 was introduced. Ustekinumab was chosen for the high efficacy rates, the high safety profile and for the reported safety in NYHA class III/IV patients. The rapid general condition improvement enabled the patient to undergo surgery. Conclusion: Anti-TNF-α drugs are contraindicated in NYHA class III/IV patients. In those cases drugs interfering with different cytokine patterns could be of interest. Although anti-IL-12/IL-23p40 has been previously addressed as unsafe in NYHA class III/IV, the clinical practice suggests that this drug can be considered quite safe. Currently the role of anti-IL-12/IL-23p40 on cardiovascular diseases is still an open question and deserves further investigations. Treatment with anti-IL-12/IL-23p40 can be considered a good option in NYHA class III/IV patients and in high- need psoriasis patients. | |
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Keywords:
Psoriasis, MACE, Anti-IL-12/IL-23p40, Ustekinumab
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Author Contributions
Auriemma Matteo – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Ruggiero Carlo – Acquisition of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Giuliani Federica – Acquisition of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Amerio Paolo – Acquisition of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published |
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Guarantor of submission
The corresponding author is the guarantor of submission. |
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Source of support
None |
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Conflict of interest
Authors declare no conflict of interest. |
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Copyright
© Auriemma Matteo et al. 2013; This article is distributed the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any means provided the original authors and original publisher are properly credited. (Please see Copyright Policy for more information.) |
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