The use of ustekinumab in patients with psoriasis and coexisting renal or hepatic dysfunction – a report of two cases

Introduction . Psoriasis is a chronic inflammatory disorder with a genetic and environmental background. The use of biological agents in cases of refractory psoriasis and psoriatic arthritis proved to be a breakthrough due to their effectiveness and safety profile. An indication for biological agents, apart from the lack of therapeutic effect, is the occurrence of side effects during conventional treatment. Commonly used systemic therapies are associated with occurrence of a cumulative toxic effect that requires modification or even discontinuation of treatment. According to the literature, ustekinumab is generally safe and well tolerated, but there is no comprehensive information about its possible adverse effects on the liver or kidneys. Objective . Presentation of two clinical cases of patients with psoriasis and renal or hepatic impairment treated with ustekinumab. Case reports. Case 1 concerns a 62-year-old woman with generalized psoriasis and chronic renal insufficiency in stage III, while case 2 concerns a 61-year-old man with generalized psoriasis and concomitant toxic liver damage. Both patients were successfully treated with ustekinumab. Conclusions . Presented cases and literature data indicate that ustekinumab is relatively safe in patients with psoriasis and concomitant renal or liver malfunction.