Adalimumab for severe psoriasis and psoriatic arthritis: An open-label study in 30 patients previously treated with other biologics
Adalimumab for severe psoriasis and psoriatic arthritis: An open-label study in 30 patients previously treated with other biologics
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DOI：
10.1016/j.jaad.2006.12.003
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发表时间：
2007-08-01
影响因子：
13.8
通讯作者：
Chimenti, Sergio
中科院分区：
文献类型：
--
作者：
Papoutsaki, Marina;Chimenti, Maria-Sole;Chimenti, Sergio
背景资料：银屑病是一种慢性、遗传决定的、免疫介导的炎症性皮肤疾病，影响约2%至3%的白人。既往报告的数据证明阿达木单抗可有效治疗银屑病关节炎和斑块型银屑病。阿达木单抗是一种完全人源抗肿瘤坏死因子α的单克隆抗体IgG 1。目的：评价阿达木单抗治疗银屑病患者的有效性和安全性，银屑病患者的疾病是难治性治疗与其他biologicalagents.Patients和方法：30例斑块型银屑病或无银屑病关节炎，无反应的常规和生物系统治疗。阿达木单抗单药治疗，剂量为40毫克，皮下注射，一周一次。结果：在第12周，26 30例（87%）达到Psample-Area and Severity Index（PASI）75;在第24周，25 30例（83%）达到PASI 75。关于银屑病关节炎，在第24周，平均健康评估问卷评分从0.99改善至0.2，里奇关节指数从10-15改善至2，疼痛视觉评估评分从6.32改善至1.2。此外，阿达木单抗治疗显著提高了患者的生活质量，通过两项指标评估（皮肤病生活质量指数、银屑病功能障碍指数）。阿达木单抗总体上是安全的，耐受性良好。局限性：这不是一项随机安慰剂对照研究，仅限于少数患者。结论：在我们的经验中，虽然是初步的，但阿达木单抗40 mg每周一次单药治疗被证明是斑块型银屑病和银屑病关节炎的有效和安全治疗，在常规药物和生物制剂均难治的患者中起效迅速。
Background: Psoriasis is a chronic, genetically determined, immune-mediated, inflammatory skin disease affecting approximately, 2% to 3% of the Caucasian population. Previously reported data demonstrated adalimumab to be an efficacious treatment of psoriatic arthritis and plaque-type psoriasis. Adalimumab is a fully human monoclonal antibody IgG1 against tumor necrosis factor alpha.Objective: To evaluate the efficacy and safety of adalimumab, in the treatment of psoriasis patients whose disease is refractory to treatment with other biologic agents.Patients and methods: Thirty patients affected by plaque-type psoriasis with or without psoriatic arthritis, unresponsive to conventional and biologic systemic treatments were enrolled. Adalimumab was administered in monotherapy, at a dosage of 40 mg, subcutaneously, once a week.Results: At week 12, 26 of 30 patients (87%) achieved Psoriasis Area and Severity Index (PASI) 75; at week 24, 25 of 30 patients (83%) achieved PASI 75. Concerning psoriatic arthritis, at week 24, the mean Health Assessment Questionnaire score improved from 0.99 to 0.2, Ritchie articular index from 10-15 to 2, and Pain Visual Assessment Score from 6.32 to 1.2. Furthermore, therapy with adalimumab considerably enhanced patients' quality of life as assessed by two measures (Dermatology Life Quality Index, Psoriasis Disability Index). Adalimumab was generally safe and well tolerated.Limitations: This is not a randomized placebo-controlled study and is restricted to a small number of patients.Conclusions: In our experience, although preliminary, monotherapy with adalimumab 40 mg weekly proved to be in effective and safe treatment for the management of plaque-type psoriasis and psoriatic arthritis,with a rap d onset of action in patients whose disease had been refractory to both conventional and biologic agents.