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Journal of the American Academy of Dermatology
Volume 63, n° 2
pages 228-234 (août 2010)
Doi : 10.1016/j.jaad.2009.08.040
accepted : 25 August 2009
Original Articles

Efficacy and safety of adalimumab in patients with plaque psoriasis who have shown an unsatisfactory response to etanercept
 

Robert Bissonnette, MD, FRCPC a, , Chantal Bolduc, MD, FRCPC a, Yves Poulin, MD, FRCPC b, Lyn Guenther, MD, FRCPC c, Charles W. Lynde, MD, FRCPC d, Catherine Maari, MD, FRCPC a
a Innovaderm Research Inc, Montreal, Quebec, Canada 
b Centre de Recherche Dermatologique du Québec Métropolitain, Quebec, Canada 
c Guenther Dermatology Research Centre, London, Ontario, Canada 
d Lynderm Research, Markham, Ontario, Canada 

Correspondence to: Robert Bissonnette, MD, Innovaderm Research Inc, 1851 Sherbrooke est, Bureau 502, Montreal, Quebec, H2K 4L5, Canada.
Abstract
Background

The safety and efficacy of adalimumab in patients who have shown an unsatisfactory response to etanercept are unknown.

Objective

We sought to evaluate the safety and efficacy of adalimumab in patients who failed to show a satisfactory response or lost their satisfactory response to etanercept.

Methods

This multicenter study enrolled patients who either failed to reach a physician global assessment (PGA) score of 0 or 1 after 12 weeks of etanercept (group A; 50 patients) or who lost their PGA score of 0 or 1 at any time after etanercept dose decrease from 50 mg twice a week to 50 mg every week (group B; 35 patients). Patients received adalimumab 40 mg 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.

Results

After 12 weeks of adalimumab, 34.0% (n = 17; 95% confidence interval [CI] 20.4-47.6) and 31.4% (n = 11; 95% CI 15.2-47.6) of patients from groups A and B, respectively, reached a PGA score of 0 or 1. A total of 46.0% (n = 23; 95% CI 31.7-60.3) and 45.7% (n = 16; 95% CI 28.4-63.1) of patients from group A and B, respectively, achieved a PGA score of 0 or 1 after 24 weeks of adalimumab. Adalimumab was well tolerated and no serious adverse events were reported.

Limitations

This was an open-label uncontrolled study.

Conclusions

Adalimumab should be considered as an alternative in patients with psoriasis who have not shown an adequate response or who lost their response to etanercept after a dose decrease.

The full text of this article is available in PDF format.

Key words : adalimumab, anti–tumor necrosis factor-alfa, etanercept, psoriasis

Abbreviations used : AE, BSA, CI, EOW, EW, PASI, PASI 75, PGA, TNF



 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.
 Reprints not available from the authors.



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