Adalimumab Effective for Unresponsive Psoriasis Patients

Clinically meaningful improvement after cessation of suboptimal therapies, short washout period

THURSDAY, April 21 (HealthDay News) -- Approximately half of the patients with psoriasis who had a suboptimal response to etanercept, methotrexate (MTX), or narrowband (NB)-ultraviolet B (UVB) phototherapy achieved a clinically meaningful improvement after immediate transition to adalimumab treatment, according to a study published in the April issue of the Journal of the American Academy of Dermatology.

Bruce E. Strober, M.D., Ph.D., from the New York University School of Medicine in New York City, and colleagues investigated the efficacy and safety of transitioning to adalimumab for the treatment of chronic plaque psoriasis. Etanercept treatment was discontinued 11 to 17 days, and MTX and NB-UVB phototherapy were stopped four to 10 days before the initiation of 16 weeks of adalimumab treatment. The study end point was measured as the percentage of patients achieving "clear" or "minimal" on the Physician Global Assessment.

The researchers found that, in total, 52 percent of patients achieved clinically meaningful improvements. Improvement was seen in 49 percent of those previously treated with etanercept, 61 percent with MTX, and 48 percent with NB-UVB phototherapy. Worsening of the Psoriasis Area and Severity Index by at least 125 percent was seen in four patients, and the safety profile of adalimumab was similar to results recorded in other trials.

"Patients had acceptable safety outcomes and a low risk of flare, despite immediate discontinuation of prior therapy and a short washout period," the authors write. "Importantly, these results suggest that such a transition to adalimumab will result in a satisfactory treatment response in approximately half of such patients."

Several of the study authors disclosed financial relationships with the pharmaceutical industry, including Abbott.

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