Two cases of hepatitis B in patients with moderate to severe psoriasis with ustekinumab

J Drugs Dermatol. 2012 Dec;11(12):1498-501.

Abstract

Background: Patients with psoriasis who are treated with systemic and biologic therapies may have an increased risk of infections, including hepatitis B virus (HBV). Cytokines that modulate CD4+ T cell subsets, including interleukin (IL)-12 and IL-23, have been suggested to play a role in the pathogenesis of HBV infection.

Objective: To report the first known cases of acute HBV infection in 2 ustekinumab-treated patients with psoriasis from a phase 3 (PHOENIX 1) and a phase 4 (TRANSIT) study.

Results: Both ustekinumab-treated patients generated an immune response toward HBV and experienced typical courses of infection, without progression to chronic HBV infection.

Conclusion: Continued monitoring of liver-related adverse events in clinical trials, registries, and spontaneous reporting from the postmarketing setting will further contribute to understanding the role of ustekinumab in viral hepatitis.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Alanine Transaminase / blood
  • Antibodies, Monoclonal, Humanized / adverse effects*
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Aspartate Aminotransferases / blood
  • Blood Chemical Analysis
  • Clinical Trials, Phase III as Topic
  • Clinical Trials, Phase IV as Topic
  • DNA, Viral / blood
  • Hepatitis B / etiology*
  • Hepatitis B Antibodies / analysis
  • Hepatitis B Surface Antigens / analysis
  • Humans
  • Liver Function Tests
  • Male
  • Psoriasis / complications*
  • Psoriasis / drug therapy*
  • Psoriasis / pathology
  • Risk
  • Skin / pathology
  • Ustekinumab

Substances

  • Antibodies, Monoclonal, Humanized
  • DNA, Viral
  • Hepatitis B Antibodies
  • Hepatitis B Surface Antigens
  • Aspartate Aminotransferases
  • Alanine Transaminase
  • Ustekinumab