Acute generalized pustular psoriasis (GPP) is a serious illness. Despite various treatment methods, there is still lack of effective treatment plans for refractory cases with multiple comorbidities. This case report presents a 67-year-old woman with acute GPP, stage 4 chronic kidney disease (CKD), type 2 diabetes, and cardiovascular disease, in whom skin symptom disappearance and kidney function improvement were observed after the use of oral tacrolimus as the sole therapy. This is the first report on the application of tacrolimus in the treatment of acute GPP, especially refractory acute GPP. The successful treatment indicates that there are shared immune pathways between acute GPP and CKD, and the pathways can be interdicted by tacrolimus. Further studies are needed to optimize the therapy to maximize efficacy and minimize toxicity.
Tag : Tacrolimus
Section scientifique
Case report: Successful treatment of acute generalized pustular psoriasis with multiple comorbidities with oral tacrolimus
Section scientifique
Real-world effectiveness and safety of advanced therapies for the treatment of moderate-to-severe ulcerative colitis (UC): evidence from a systematic literature review (SLR)
Makoto Naganuma 1, Taku Kobayashi 2, Reiko Kunisaki 3, Katsuyoshi Matsuoka 4, Shojiro Yamamoto 5, Ami Kawamoto 6, Daisuke Saito 7, Kosaku Nanki 8, Kazuyuki Narimatsu 9, Hisashi Shiga 10, Motohiro Esaki 11, Shinichiro Yoshioka 12, Shingo Kato 13, Masayuki Saruta 14, Shinji Tanaka 15, Eriko Yasutomi 16, Kaoru Yokoyama 17, Kei Moriya 18, Yoshikazu Tsuzuki 19, Makoto Ooi 20, Mikihiro Fujiya 21, Atsushi Nakazawa 22, Takayuki Abe 23, Tadakazu Hisamatsu 6; Japanese UC Study Group J Gastroenterol. 2023 Dec;58(12):1198-1210. doi: 10.1007/s00535-023-02048-w.
Background: This multicenter observational cohort study aimed to evaluate the utilization and short-term efficacy of advanced therapy (AT) in hospitalized patients with acute severe ulcerative colitis (ASUC).
Methods: In total, 221 patients with ASUC were enrolled between August 2020 and July 2021. The primary endpoint was clinical remission (CR, defined as a patient-reported outcome score < 2 with no blood in the stool) rate on Day 7 and 14 in hospitalized patients who received corticosteroids (CS) and AT.
Results: Among patients with ASUC, 120 and 101 patients received CS or any AT as first-line treatment, respectively. The CR rates on Day 7 and 14 were 22.5% and 35.0%, respectively, in hospitalized patients who received CS as first-line treatment. Most patients who used ATs had CS-dependent or frequent recurrences. Eight different ATs (apheresis, tacrolimus, infliximab, golimumab, tofacitinib, vedolizumab, ustekinumab, and cyclosporine) were used as first-line treatment in patients with ASUC, and the CR rates on Day 7 and 14 were 16.8% and 29.7%, respectively. Twenty-five patients received the second ATs after hospitalizations, and the CR rates on Day 7 and 14 were 0% and 12%, respectively. The CR rates on Day 14 were significantly higher in patients who changed to AT than in those whose dose of CS increased (34.0% vs 10.7%, p = 0.020) among patients who had already used CS before hospitalization.
Conclusion: Most first-use ATs were effective for patients with ASUC, while second-use ATs might have had limited benefits in inducing CR. These findings may contribute to considerations for the management of hospitalized patients.
Section scientifique
P442 The additional value of cytapheresis therapy in patients with severe ulcerative colitis treated with oral tacrolimus
S Takahashi, M Colvin, J Toyosawa, M Ishida, T Kagawa, S Kuraoka, Y Aoyama, K Okamoto, I Sakakihara, K Izumikawa, K Yamamoto, S Tanaka, M Matsuura, S Ishikawa, M Wato, T Hasui, T Inaba, Journal of Crohn’s and Colitis, Volume 12, Issue supplement_1, February 2018
Cytapheresis therapy as an additional therapy to oral tacrolimus is effective in patients with severe ulcerative colitis.
Section scientifique
Successful remission of ulcerative colitis flare-up during pregnancy with adsorptive granulomonocytapheresis plus tacrolimus
Tomoyoshi Shibuya 1, Keiichi Haga 1, Masato Kamei 1, Koki Okahara 1, Shoko Ito 1, Masahito Takahashi 1, Osamu Nomura 1, Takashi Murakami 1, Masae Makino 1, Tomohiro Kodani 1, Dai Ishikawa 1, Naoto Sakamoto 1, Taro Osada 1, Tatsuo Ogihara 1, Sumio Watanabe 1, Akihito Nagahara 1 , Intest Res. 2018 Jul;16(3):484-488.
Our experience indicates that GMA, as a non-drug therapeutic intervention with a favorable safety profile, plus tacrolimus might be a relevant treatment option for patients with active IBD during pregnancy. A future study of a large cohort of pregnant patients should strengthen our findings.
Contactez-nousPour en savoir plus
Contactez-nous