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

Abstract

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.

Impact of obesity on the effectiveness of adalimumab for the treatment of psoriasis: a retrospective study of 30 patients in daily practice

“…Patients with moderate to severe psoriasis constitute about 30% of the psoriasis population [20]. This subset of patients presents a challenge due to the long-term side effects, toxicities and inconveniences of conventional treatments, including phototherapy, methotrexate and cyclosporine.…”

“…Advances in the understanding of the pathogenesis of psoriasis have led to the use of biologics, which offer a safer and more effective targeted therapy [21]. There is strong evidence of the efficacy and safety of adalimumab for psoriasis derived from pivotal studies (one with an extension study up to 3 years), pooled data of randomized control trials with biologics and systematic reviews of the literature [20,[22][23][24][25][26][27][28][29][30][31]. Also, it has been shown that adalimumab is highly effective in the subset of patients not responding to other biologic treatments, and that adalimumab is more likely to be continued than treatment with other anti-TNF␣ agents [32][33][34][35][36].…”