ReportAdalimumab for severe psoriasis and psoriatic arthritis: An open-label study in 30 patients previously treated with other biologics
Section snippets
Patients
Thirty patients (20 males and 10 females) affected by plaque-type psoriasis, with a Psoriasis Area and Severity Index (PASI) score ranging from 3 to 67.2, (median PASI score, 16.4; PASI interquartile range, 14.5) were enrolled. Nineteen of these patients suffered also from psoriatic arthritis. Some of the patients suffering from psoriatic arthritis were enrolled in the study, although they presented a low PASI score (PASI ≤ 10), while all patients suffering from plaque-type psoriasis had a PASI
Results
Twenty-seven of 30 patients concluded the 24-week treatment. Three patients withdrew from the study, one at the 12th, one at the 16th, and one at the 20th week, because of lack of efficacy (PASI 50 not achieved or maintained beyond week 12). In those patients who continued, significant improvement in PASI score was seen after 4 weeks of treatment (reduction of mean PASI score from 19.2 to 8.9) and the efficacy continued to improve at week 8. At week 12, 27 of 30 patients (90%) achieved an
Discussion
Systemic therapy for moderate to severe psoriasis has previously consisted largely of immunosuppressive agents such as methotrexate and cyclosporine. Increasing insight into the immunopathogenesis of psoriasis has led to new developments in the field of psoriasis pharmacotherapy. The current pathogenic model is based on a type 1 immune response mediated by type 1 helper T-cell and type 1 cytotoxic T-cell lymphocytes secreting a specific cytokine profile (interferon-γ, TNF-α, and interleukin 2).
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Supported in part by the Italian Ministry of Health (Prog. Finalizzati Regione Lazio).
Disclosure: Dr S. Chimenti has served as a consultant and speaker for Wyeth, Centocor, and Schering-Plough.