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Giornale Italiano di Dermatologia e Venereologia 2020 Feb 05

DOI: 10.23736/S0392-0488.19.06410-1


language: English

Helicobacter Pylori infection in psoriatic patients during biological therapy

Federico BARDAZZI 1, Michela MAGNANO 1, Giulia FIORINI 2, Dino VAIRA 2, Giulia ODORICI 3 , Gabriele BERTUSI 1, Annalisa PATRIZI 1

1 Department of Clinical, Experimental and Specialty Medicine, Division of Dermatology, University of Bologna, Bologna, Italy; 2 Department of Surgical and Medical Sciences, University of Bologna, Bologna, Italy; 3 Department of Surgical, Medical, Dental and Morphological Sciences with Interest Transplant, Oncological and Regenerative Medicine, Dermatology Unit, University of Modena and Reggio Emilia, Modena, Italy


BACKGROUND AND OBJECTIVE: Psoriasis is a relapsing inflammatory disease exacerbated by many triggers. Helicobacter Pylori (H. Pylori) is a Gram-negative bacterium causing the liberation of many cytokines and having a role in systemic inflammation. We assessed over a period of 12 months the presence of H. Pylori in psoriatic patients undergoing biologic therapy and how PASI improved after its eradication.
METHODS: We performed an interventional, prospective, cohort, exploratory and mono-centric study in patients affected by moderate-severe psoriasis during biological therapy to assess the correlation between psoriasis (moderate to severe forms), and H. Pylori infection. We also checked if the bacterial eradication could improve the severity of psoriasis throughout the variation of PASI over a 12-month period.
RESULTS: The prevalence of H. Pylori was 35%. The average of PASI improved in H. Pylori positive patients after the eradication (confidence interval= 33-44; p= 0.023). H. Pylori positive patients were more likely to have psoriatic arthropathy (p=0.049). Gastrointestinal symptoms (such as epigastric pain, postprandial heaviness, pyrosis) were found in only 31.3% of H pylori positive patients.
CONCLUSIONS: Since the H. Pylori infection is often asymptomatic, it can be useful to perform the 13C-Urea breath test, and to eradicate it before to start the psoriasis therapy, in order to decrease the level of inflammation.

KEY WORDS: Psoriasis; Helicobacter Pylori; Biological therapy

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