Efficacy of adalimumab in the treatment of psoriasis: A retrospective study of 15 patients in daily practice

Abstract

Background: Adalimumab is a fully human IgG1 monoclonal antibody that binds to tumor necrosis factor (TNF), a key proinflammatory cytokine involved in the pathogenesis of psoriasis. Objective: A single-center, retrospective study was conducted to assess the efficacy and safety of adalimumab in patients with moderate to severe psoriasis in daily practice. Methods: The medical records of 15 patients with moderate to severe psoriasis treated with adalimumab during a 1-year period were reviewed. Previous conventional systemic treatments or other biological agents were unsuccessful. All patients received subcutaneous injections of an initial dose of adalimumab (80 mg) at week 0 followed by adalimumab (40 mg) every other week. Results: A 75% improvement in the Psoriasis Area and Severity Index (PASI 75) score was achieved by 80% of patients at week 24 and by 73.3% of patients at week 48. Moreover, 13.3% of patients were almost completely cleared (PASI 90) at week 48. At 24 weeks, adalimumab therapy increased significantly a patient's quality of life as assessed by the Dermatology Life Quality Index (DLQI) (p = 0.001). The Nail Psoriasis Severity Index (NAPSI) decreased from a mean (SD) of 18.9 (12.2) to 8.2 (4.7) (p = 0.001) at week 24. Palmoplantar psoriasis decreased from a mean score of 1.1 (1.3) to 0.5 (0.9) (p = 0.026) and scalp involvement from a mean of 2.5 (1.2) to 1.1 (1.0) (p = 0.002) at week 24. Out of 11 patients with pruritus at the pre-treatment visit, this symptom had completely disappeared in nine of them after 24 weeks of treatment. Conclusions: Treatment with adalimumab proved to be effective for the management of chronic moderate to severe plaque-type psoriasis in patients whose disease had been refractory to systemic conventional therapies or other biologic agents.