Volume 63, Issue 2 , Pages 228-234, August 2010
Efficacy and safety of adalimumab in patients with plaque psoriasis who have shown an unsatisfactory response to etanercept
Background
The safety and efficacy of adalimumab in patients who have shown an unsatisfactory response to etanercept are unknown.
Objective
We sought to evaluate the safety and efficacy of adalimumab in patients who failed to show a satisfactory response or lost their satisfactory response to etanercept.
Methods
This multicenter study enrolled patients who either failed to reach a physician global assessment (PGA) score of 0 or 1 after 12 weeks of etanercept (group A; 50 patients) or who lost their PGA score of 0 or 1 at any time after etanercept dose decrease from 50 mg twice a week to 50 mg every week (group B; 35 patients). Patients received adalimumab 40 mg every other week without loading dose for 12 weeks followed by 40 mg every week for an additional 12 weeks if they did not reach a PGA score of 0 or 1.
Results
After 12 weeks of adalimumab, 34.0% (n = 17; 95% confidence interval [CI] 20.4-47.6) and 31.4% (n = 11; 95% CI 15.2-47.6) of patients from groups A and B, respectively, reached a PGA score of 0 or 1. A total of 46.0% (n = 23; 95% CI 31.7-60.3) and 45.7% (n = 16; 95% CI 28.4-63.1) of patients from group A and B, respectively, achieved a PGA score of 0 or 1 after 24 weeks of adalimumab. Adalimumab was well tolerated and no serious adverse events were reported.
Limitations
This was an open-label uncontrolled study.
Conclusions
Adalimumab should be considered as an alternative in patients with psoriasis who have not shown an adequate response or who lost their response to etanercept after a dose decrease.
Key words: adalimumab, anti–tumor necrosis factor-alfa, etanercept, psoriasis
Abbreviations used: AE, adverse events, BSA, body surface area, CI, confidence interval, EOW, every other week, EW, every week, PASI, Psoriasis Area and Severity Index, PASI 75, reduction in PASI by 75% or more, PGA, physician global assessment, TNF, tumor necrosis factor
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Supported by Innovaderm Research Inc and an investigator grant from Abbott Laboratories.
Disclosure: Dr Bissonnette has been a speaker, consultant, investigator, and/or advisory board member for Abbott, Amgen-Wyeth, Astellas-Pharma, Celgene, Centocor, EMD Serono, Galderma, Isotechnika, Leo Pharma, MedImmune, Ortho Biotech, Pfizer, and Schering-Plough Canada. He has received compensation in the form of grants and/or honoraria from these companies. Dr Bolduc has been a speaker, consultant, investigator, or advisory board member for Leo Pharma, Abbott, Amgen-Wyeth, Centocor, MedImmune, and Schering-Plough Canada. She has received compensation in the form of grants and/or honoraria from these companies. Dr Guenther has been a speaker, consultant, investigator, and advisory board member for Abbott, Amgen, Astellas-Pharma, Centocor, EMD Serono, Leo Pharma, Ortho Biotech, Novartis, Schering-Plough, and Wyeth. Dr Lynde has acted as a speaker and consultant for Astellas-Pharma, EMD Serono, Schering-Plough Canada, Abbott, Leo Pharma, and Amgen and receives compensation in the form of grants and honoraria. Dr Maari has been a speaker, consultant, investigator, and/or advisory board member for Abbott, Amgen-Wyeth, Astellas-Pharma, Centocor, Galderma, MedImmune, Ortho Biotech, and Schering-Plough Canada. She has received compensation in the form of grants and/or honoraria from these companies. Dr Poulin has been a speaker, consultant, investigator, and/or advisory board member for Abbott, Amgen-Wyeth, Astellas-Pharma, Bristol-Myers Squibb, Boehringer-Ingelheim, Centocor, EMD Serono, Galderma, Ortho Biotech, and Schering-Plough Canada. He has received compensation in the form of grants and/or honoraria from these companies.
Reprints not available from the authors.
PII: S0190-9622(09)01150-5
doi:10.1016/j.jaad.2009.08.040
© 2009 American Academy of Dermatology, Inc. Published by Elsevier Inc All rights reserved.
Volume 63, Issue 2 , Pages 228-234, August 2010
