Critical appraisal of adalimumab in the treatment of chronic plaque psoriasis

Abstract

Psoriasis is a chronic inflammatory disease estimated to affect 1%-3% of the worldwide population. It is not simply a cutaneous disease but also poses a significant medical, social, and economic burden worldwide. Tumor necrosis factor (TNF)-α inhibitors are currently amongst the most important drugs in the therapeutic management of psoriasis. Patients using TNF-α inhibitors are at risk for infections including active and latent tuberculosis. Adalimumab, one of the TNF-α inhibitors, is a fully human monoclonal antibody that received approval for the treatment of chronic plaque psoriasis in 2008. Its use has been studied extensively for its safety and efficacy profile in the clinical setting. For the purpose of this review, we accessed the major publications in English relating to the use of adalimumab for psoriasis. Adalimumab appears to be one of the most efficacious biologic agents for the treatment of psoriasis. Results from various clinical trials including the REVEAL, CHAMPION, and BELIEVE are included in this review. The most recent data from an ongoing post-marketing study (ESPRIT) is also included in the analysis. Research regarding the safety, efficacy, and patient-reported outcomes support a favorable risk-benefit profile for adalimumab.