Original articleEfficacy and safety of adalimumab in patients with plaque psoriasis who have shown an unsatisfactory response to etanercept
Section snippets
Patients
To be eligible, patients had to be between 18 and 80 years of age and have plaque psoriasis at screening that was severe enough for a systemic therapy. Patients with poorly controlled medical conditions such as uncontrolled diabetes; patients with symptoms of demyelinating diseases, a history of cancer, listeriosis, tuberculosis, persistent chronic infections, or immunodeficiency; or patients who had taken live attenuated vaccine within 28 days of baseline were excluded from the study.
All
Demographics and patient disposition
A total of 85 patients were included in this study (50 patients in group A and 35 patients in group B). The original plan was to include 50 patients in both groups. However, recruitment of patients who presented a PGA score of 0 or 1 after 12 weeks of etanercept followed by an increase in PGA score to 2 or higher upon etanercept dose reduction was more difficult than anticipated. As recruitment was not progressing, it was decided to stop enrollment during the spring of 2008. Demographics of
Discussion
Treatment of patients with moderate to severe psoriasis has changed dramatically since the approval of biological agents. In addition to topical therapy, phototherapy, and the oral systemic agents, there are, at the time of this writing, 5 biologics approved in various countries for the treatment of psoriasis with at least one more pending approval.7, 8 Choosing the best treatment for moderate to severe psoriasis becomes more complex both for patients and clinicians. Biologics targeting
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Efficacy and safety of immune checkpoint inhibitors and cytokine therapy in autoimmune diseases
2022, Translational Autoimmunity: Treatment of Autoimmune DiseasesJoint AAD-NPF guidelines of care for the management and treatment of psoriasis with biologics
2019, Journal of the American Academy of DermatologyCitation Excerpt :Retreatment after discontinuation may result in a small percentage of patients not being able to recapture their previous robust level of response.73,75,153,154,207 If clinically needed, all other therapies for psoriasis, including other biologics, may be switched with a different biologic agent with the possibility of improved efficacy, safety, and/or tolerability.152,239,293,300,308-323 It is important to stress that not all switches may result in improvement and that, at this time, there are insufficient data to make more specific recommendations.
The risk of malignancy among biologic-naïve pediatric psoriasis patients: A retrospective cohort study in a US claims database
2017, Journal of the American Academy of DermatologyEtanercept
2016, Therapy for Severe PsoriasisAdalimumab
2016, Therapy for Severe PsoriasisSystematic review of efficacy of anti–tumor necrosis factor (TNF) therapy in patients with psoriasis previously treated with a different anti–TNF agent
2016, Journal of the American Academy of DermatologyCitation Excerpt :Two studies, specifically designed to include only patients with prior etanercept failure who would switch to adalimumab, reported PGA score 0/1 rates of 49% at 16 weeks (n = 82)14 and 46% at 24 weeks (n = 85)15; an open-label study of patients switching to adalimumab from multiple anti–TNF therapies reported that 21% of the 14 patients switching from etanercept to adalimumab achieved a PGA score of 0/1 at weeks 16 and 24.8 The PASI75 response rates varied among studies, from 27% to 77% after 12 to 24 weeks of adalimumab therapy (Fig 1, B).8,11-13,15,18-21 Two of the 3 studies that reported results for later time points (≥48 weeks; n = 30 and n = 12)12,19 showed increased rates with longer adalimumab treatment, whereas the other (n = 35) reported a similar rate over time.13
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.
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