Long‐term efficacy of adalimumab in generalized pustular psoriasis

Zangrilli, Arianna; Papoutsaki, Marina; Talamonti, Mark S.; Chimenti, Sergio

doi:10.1080/09546630701759587

Cited by 32 publications

(32 citation statements)

References 17 publications

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“…The PASI scores were stably maintained over 48 weeks, even following a reduction to weekly 50 mg dosing at 24 weeks. Adalimumab has shown efficacy in adolescence and adulthood through 72 weeks of treatment (grade D evidence) [80–82]. …”

Section: Resultsmentioning

confidence: 99%

A Delphi Consensus Approach to Challenging Case Scenarios in Moderate-to-Severe Psoriasis: Part 2

Strober

Cather

Cohen

et al. 2012

Dermatol Ther (Heidelb)

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IntroductionClinicians may be confronted with difficult-to-treat psoriasis cases for which there are scant data to rely upon for guidance. To assist in managing such patients, who are typically excluded from clinical trials, a consensus panel of 14 experts in the field of psoriasis was formed to conduct a Delphi method exercise.MethodsThe exercise consisted of both survey questionnaires and a live meeting to review and discuss current data (as of 2009, when the exercise was conducted) and arrive at a consensus for optimal treatment options. Seventy difficult treatment scenarios were identified, and the top 24 were selected for discussion at the live meeting.ResultsFive of the 24 discussed case scenarios are presented in this article: (1) moderate-to-severe psoriasis that has failed to respond to all currently approved therapies for psoriasis; (2) palmoplantar psoriasis that is unresponsive to topical therapy and phototherapy; (3) erythrodermic psoriasis; (4) pustular psoriasis; and (5) the preferred therapeutic choice to combine with low-dose methotrexate. A previous article (part 1) presented six other scenarios.ConclusionThe Delphi exercise resulted in guidelines for practicing physicians to utilize when confronted with patients with challenging cases of psoriasis.

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Section: Resultsmentioning

confidence: 99%

A Delphi Consensus Approach to Challenging Case Scenarios in Moderate-to-Severe Psoriasis: Part 2

Strober

Cather

Cohen

et al. 2012

Dermatol Ther (Heidelb)

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“…It has been suggested that this paradoxical response appears to involve a disruption in cytokine balance following TNFα inhibition, resulting in the upregulation of plasmacytoid dendritic cells and the subsequent production of unopposed interferon-alpha, following a triggering event in predisposed individuals 102. Notably, adalimumab has not only been reported to cause pustular psoriasis, but also to be effective in the treatment of recalcitrant generalized pustular psoriasis in adults and adolescents 83,84…”

Section: Resultsmentioning

confidence: 99%

Targeted treatment of psoriasis with adalimumab: a critical appraisal based on a systematic review of the literature

Schmitt

Wozel²

2009

BTT

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Psoriasis is a chronic inflammatory disease affecting 2% to 3% of the population in Western countries. Psoriasis is associated with limited quality of life, cardiovascular disease, and depression. The approval of injectable biological agents has revolutionized the management of moderate to severe psoriasis. Adalimumab is a human monoclonal antibody against tumor necrosis factor (TNF) alpha approved for moderate-to-severe plaque-type psoriasis and psoriatic arthritis (PsA). This systematic review summarizes the evidence concerning the efficacy, clinical effectiveness, safety, and cost-effectiveness of adalimumab in the treatment of psoriasis. Five randomized controlled trials demonstrated the efficacy of adalimumab in moderate-to-severe plaque-type psoriasis and PsA with PASI-75 response rates of 53% to 80% and ACR-20 response rates of 39% to 58% after 12 to 16 weeks of treatment. In clinical practice patients who have not responded to one TNF antagonist may respond to another TNF antagonist. Adalimumab has similar or better cost-effectiveness than other biologics, but is less efficient than methotrexate and cyclosporine. Adalimumab is generally well tolerated. Patients should be evaluated for active/latent tuberculosis, serious infections, and other contraindications prior to initiation of adalimumab therapy. Future studies should investigate the comparative efficacy of adalimumab and other biologic and prebiologic agents. Recently established registries will yield additional data on the effectiveness and long-term safety of adalimumab.

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“…Multiple reports on the induction or exacerbation of psoriasis in patients treated with TNF-α antagonists exist,51 including such cases associated with adalimumab as new onset generalized pustular psoriasis and52 pustular psoriasis of the scalp 51. Although it has been reported to cause pustular psoriasis, adalimumab has also been found to be effective in the treatment of recalcitrant generalized pustular psoriasis in adults53 and adolescents 54. Therefore, adalimumab-induced psoriasis requires discontinuation of adalimumab only in cases unresponsive to topical anti-psoriatic treatment.…”

Section: Safety and Tolerability Of Adalimumab In The Long-term Treatmentioning

confidence: 99%

Long-term use of adalimumab in the treatment of moderate to severe plaque psoriasis: a review of the literature

Moore

Richardson²

2010

CCID

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Psoriasis is a chronic T-cell-mediated inflammatory disease that primarily affects the skin and joints. Patients with moderate to severe psoriasis constitute about 30% of the psoriasis population. Treatment of this group is challenging due to the long-term side effects, toxicities and inconvenience of conventional treatments such as phototherapy, methotrexate and cyclosporine. However, recent advances in our understanding of the pathogenesis of psoriasis have led to the popular use of biologics, which offer a safer, more convenient and effective targeted therapy. Adalimumab was originally approved for treating rheumatoid arthritis. Currently, adalimumab is also approved for treatment of adult patients with moderate to severe chronic plaque psoriasis who are candidates for systemic therapy or phototherapy or when other systemic therapies are medically less appropriate. Since the onset of the use of biologics, there have been concerns over safety and efficacy when used as long-term therapy. This paper reviews all publications, posters and abstracts reporting original data on the efficacy and/or safety of adalimumab in patients treated for chronic plaque psoriasis for more than 1 year.

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Long‐term efficacy of adalimumab in generalized pustular psoriasis

Abstract: In this case, adalimumab has been demonstrated to be effective, safe and appropriate for long-term use, indicating a beneficial effect on quality of life parameters.

Cited by 32 publications

References 17 publications

A Delphi Consensus Approach to Challenging Case Scenarios in Moderate-to-Severe Psoriasis: Part 2

A Delphi Consensus Approach to Challenging Case Scenarios in Moderate-to-Severe Psoriasis: Part 2

Targeted treatment of psoriasis with adalimumab: a critical appraisal based on a systematic review of the literature

Long-term use of adalimumab in the treatment of moderate to severe plaque psoriasis: a review of the literature

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