Observational Study
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Feb 27, 2018; 10(2): 329-336
Published online Feb 27, 2018. doi: 10.4254/wjh.v10.i2.329
Outcomes assessment of hepatitis C virus-positive psoriatic patients treated using pegylated interferon in combination with ribavirin compared to new Direct-Acting Antiviral agents
Giovanni Damiani, Chiara Franchi, Paolo Pigatto, Andrea Altomare, Alessia Pacifico, Stephen Petrou, Sebastiano Leone, Maria Caterina Pace, Marco Fiore
Giovanni Damiani, Study Center of Young Dermatologists Italian Network (YDIN), Gised, Bergamo, Italy and Clinical Dermatology, IRCCS Galeazzi Orthopaedic Institute, Milan 20126, Italy
Giovanni Damiani, Chiara Franchi, Paolo Pigatto, Andrea Altomare, Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan 20126, Italy
Chiara Franchi, Paolo Pigatto, Andrea Altomare, Clinical Dermatology, IRCCS Galeazzi Orthopaedic Institute, Milan 20126, Italy
Alessia Pacifico, San Gallicano Dermatological Institute, IRCCS, Rome 00144, Italy
Stephen Petrou, Department of Emergency Medicine, St. George’s University Medical School, Grenada, West Indies
Sebastiano Leone, Division of Infectious Diseases, “San Giuseppe Moscati” Hospital, Avellino 83100, Italy
Maria Caterina Pace, Marco Fiore, Department of Anesthesiological, Surgical and Emergency Sciences, University of Campania “Luigi Vanvitelli”, Naples 80138, Italy
Author contributions: Damiani G and Pigatto P designed the research; Franchi C, Pigatto P and Pacifico A performed the research; Damiani G analyzed the data; Altomare A and Pace MC supervised the manuscript; Petrou S revised the manuscript in order to improve and polish language; Damiani G, Leone S and Fiore M wrote the paper.
Institutional review board statement: This study was approved by the Institutional Review Board of I.R.C.C.S. Istituto Ortopedico Galeazzi (Milan, Italia).
Informed consent statement: Informed consent was obtained from all HCV positive patients undergoing antiviral therapy after a careful explanation of the nature of the disease and possible complications.
Conflict-of-interest statement: All authors declare no conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Marco Fiore, MD, Department of Anesthesiological, Surgical and Emergency Sciences, University of Campania “Luigi Vanvitelli”, Piazza Miraglia 2, Naples 80138, Italy. marco.fiore@unicampania.it
Telephone: +39-08-15665180
Received: November 27, 2017
Peer-review started: November 28, 2017
First decision: December 13, 2017
Revised: December 18, 2017
Accepted: January 23, 2018
Article in press: January 23, 2018
Published online: February 27, 2018
Research background

Up to 0.06% of people suffer from both psoriasis and hepatitis C virus (HCV). Psoriatic patients with HCV are excluded by randomized controlled clinical trials.

Research motivation

No data is currently available concerning the concomitant administration of biological drugs and the medications approved for the treatment of HCV infection, as new Direct-Acting Antiviral agents (DAAs).

Research objectives

Evaluate the outcomes in biological treatment and quality of life of psoriatic patients with chronic hepatitis C (CHC) treated with new DAAs compared to pegylated interferon-2α plus ribavirin (P/R) therapy.

Research methods

Psoriatic patients, in biological therapy, who underwent anti-HCV treatment were retrospectively reviewed. The patients were divided into two groups: patients that underwent therapy with DAAs and patients that underwent HCV treatment with P/R. Patients were assessed for Psoriasis Area Severity Index (PASI) scores and the Dermatology Quality of Life Index (DLQI) switching to a different bDMARD, dropout of HCV therapy and sustained virological response (SVR).

Research results

Twenty-seven patients were treated with DAAs and thirty-two with P/R. At three months, after completion of antiviral therapy, the DLQI and the PASI scores were significantly lower (P < 0.001 and P < 0.005, respectively) in DAAs group compared with P/R group. None of the patients in the DAAs group compared to the eight patients of the P/R group needed a change in biological treatment.

Research conclusions

DAAs seem to be more effective and safe than P/R in HCV-positive psoriatic patients on biological treatment.

Research perspectives

This is the first study which evaluated the HCV treatment of psoriatic patients on biological agents. Future studies are needed to evaluate the effects of DAAs in this clinical setting, which may further aid in elucidating the etiologic and pathogenetic mechanism of psoriasis.