Adalimumab effective following an unsatisfactory etanercept response
MedWire News: Adalimumab is an effective treatment option for patients with plaque psoriasis who have not shown an adequate response or have lost their response to etanercept after a dose decrease, say researchers.
They found that 46% of patients with psoriasis who showed an unsatisfactory response to etanercept had a satisfactory response, as defined by a physician global assessment (PGA) score of 0 or 1, following 24 weeks of adalimumab treatment.
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Robert Bissonnette, from Innovaderm Research Inc, Montreal, Quebec, Canada, and colleagues enrolled 50 psoriasis patients who had an unsatisfactory response to at least 3 months of etanercept at 50 mg twice a week without dose reduction (group A) and 35 psoriasis patients who had a PGA score of 0 or 1 (clear or almost clear) after at least 3 months with the same dose of etanercept followed by a loss of this PGA response after a dose reduction to 50 mg once a week (group B).
The patients, all of whom had a baseline PGA score of at least 3, were given 40 mg of adalimumab 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.
After 12 weeks of treatment, 34.0% of patients in group A and 31.4% of those in group B had achieved a PGA score of 0 or 1. Of those patients who did not achieve a PGA score of 0 or 1 at 12 weeks, 32.3% of those in group A and 30.4% of those in group B did after 24 weeks of treatment.
In addition, at week 24, patients in group A achieved an average 53.0% reduction in the body surface area affected by psoriasis, and 52.0% achieved a 75% improvement in their Psoriasis Area Severity and Index score. For group B, the corresponding rates were 59.3% and 62.9%.
Adalimumab was well tolerated, with no patients withdrawing from the study because of adverse events.
Bissonnette and team write in the Journal of the American Academy of Dermatology: “This study showed that adalimumab is safe and effective in patients who have shown an unsatisfactory or loss of response to etanercept.”
They conclude that adalimumab should be considered as a treatment alternative in these patients.
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By Lucy Piper