An observational, prospective study of monthly adalimumab therapy for disease maintenance in psoriasis patients: a possible new therapeutic option for good responders to the initial induction treatment
An observational, prospective study of monthly adalimumab therapy for disease maintenance in psoriasis patients: a possible new therapeutic option for good responders to the initial induction treatment
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DOI：
10.1111/j.1468-3083.2012.04610.x
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发表时间：
2013-11-01
影响因子：
9.2
通讯作者：
Adachi, M.
中科院分区：
文献类型：
--
作者：
Taniguchi, T.;Noda, S.;Adachi, M.
背景 虽然阿达木单抗是中度至重度慢性斑块型银屑病的主要治疗方法，但有关维持治疗的最佳治疗间隔的数据有限。目的 比较阿达木单抗每两周维持给药与每月治疗的临床疗效。方法 17 名银屑病患者每隔一周接受阿达木单抗 40mg 治疗，初始负荷剂量为 80mg，直至第 24 周，被分配至每隔一周接受阿达木单抗 40mg 维持治疗（n=7），或每月接受阿达木单抗 40mg（n=10）。治疗效果通过第36周、第48周和第60周时从基线达到PASI 75的患者比例来评估。两组之间不存在选择偏倚。结果 在第 24 周，每组除一名患者外，所有患者均达到 PASI 75。在两组中，所有在第 24 周达到 PASI 75 的患者在第 60 周均维持 PASI 75 反应。对于在第 24 周未达到 PASI 75 的两名患者，一名每两周治疗的患者出现治疗反应逐渐增加，而一名每月治疗的患者在第 24 周后出现恶化。结论 每月阿达木单抗治疗似乎是 为对初始标准阿达木单抗治疗 24 周反应良好的患者提供合理的治疗选择。由于本研究存在一些局限性，包括患者数量、观察期和患者特征，因此需要大型随机对照试验来证实这些结果。
Background While adalimumab is a mainstay of treatment for moderate to severe chronic plaque psoriasis, the data regarding optimal treatment intervals for therapeutic maintenance are limited. Objective We compared the clinical efficacy of biweekly maintenance administration of adalimumab with that of monthly treatment. Methods 17 psoriasis patients treated with adalimumab 40mg every other week with initial loading dose of 80mg until week 24 were assigned to the maintenance therapy with adalimumab 40mg either every other week (n=7), or every month (n=10). The treatment efficacy was evaluated by the proportion of patients who achieved PASI 75 from the baseline at weeks 36, 48 and 60. There was no selection bias between the two groups. Results At week 24, all the patients except for one in each group achieved PASI 75. In both groups, all the patients who achieved PASI 75 at week 24 maintained PASI 75 responses at week 60. Regarding two patients who did not achieve PASI 75 at week 24, one biweekly treated patient experienced a gradual increase in therapeutic response while one monthly treated patient showed exacerbation after week 24. Conclusion Monthly adalimumab treatment seems to be a reasonable treatment option for patients who responded well to initial standard adalimumab treatment for 24weeks. Since there are several limitations in this study, including the number of patients, observation period, and patients' characteristics, large randomized controlled trials are needed to confirm these results.