Efficacy and safety of adalimumab in patients with plaque psoriasis who have shown an unsatisfactory response to etanercept
Efficacy and safety of adalimumab in patients with plaque psoriasis who have shown an unsatisfactory response to etanercept
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DOI：
10.1016/j.jaad.2009.08.040
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发表时间：
2010-08-01
影响因子：
13.8
通讯作者：
Maari, Catherine
中科院分区：
文献类型：
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作者：
Bissonnette, Robert;Bolduc, Chantal;Maari, Catherine
背景资料：阿达木单抗在依那西普治疗无效患者中的安全性和有效性尚不清楚。目的：我们试图评估阿达木单抗在依那西普治疗无效或无效患者中的安全性和有效性。方法：这项多中心研究招募了接受依那西普治疗12周后医生总体评估（PGA）评分未达到0或1的患者（A组; 50例患者）或依那西普剂量从50 mg每周两次降至50 mg每周一次后任何时间PGA评分均为0或1的患者（B组; 35例患者）。患者接受阿达木单抗40 mg，每隔一周一次，不接受负荷剂量，持续12周，如果PGA评分未达到0或1分，则接受阿达木单抗40 mg，每周一次，持续12周。A组和B组分别有31.4%（n = 17; 95%置信区间[CI] 20.4-47.6）和31.4%（n = 11; 95% CI 15.2-47.6）的患者达到PGA评分0或1。阿达木单抗治疗24周后，A组和B组分别有46.0%（n = 23; 95% CI 31.7-60.3）和45.7%（n = 16; 95% CI 28.4-63.1）的患者达到PGA评分0或1。阿达木单抗耐受性良好，没有严重的不良事件reported.Limitations：这是一个开放标签的uncontrolled study.Conclusions：阿达木单抗应被视为替代银屑病患者谁没有表现出足够的反应或谁失去了对依那西普的反应后，剂量减少。（J Am Acad Dermatol 2010;63：228-34.）
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. (J Am Acad Dermatol 2010;63:228-34.)