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Influence of psoriatic arthritis on the efficacy of adalimumab and on the treatment response of other markers of psoriasis burden: subanalysis of the BELIEVE study.

AbstractBACKGROUND:
Adalimumab is a fully human anti-TNF monoclonal antibody with demonstrated efficacy and safety in patients with moderate to severe psoriasis and psoriatic arthritis (PsA).
OBJECTIVE:
This study examined the effect of PsA on adalimumab treatment response in patients from the Phase IIIb BELIEVE trial (NCT00574249, ClinicalTrials.gov registry), and response of other markers of disease burden to adalimumab treatment.
METHODS:
In this post hoc analysis, patients with or without a history of PsA and with moderate to severe psoriasis were randomized to adalimumab plus adjunctive topical therapy (calcipotriol/betamethasone dipropionate) or monotherapy (adalimumab plus matching topical vehicle).
RESULTS:
Regardless of baseline PsA, improvement at Week 16 was seen in PASI 75, pruritus, PSSI, and DLQI (all patients), and mean NAPSI scores. Patients with PsA had HAQ improvement at Week 16, and compared to patients without PsA, had higher VAS pain scores. This analysis represents the first publication of the influence of PsA and PsA plus body weight on patient response to adalimumab, and response of scalp psoriasis, nail psoriasis, and patient-reported outcomes to adalimumab. The incidence of AEs was similar among all patients (62%), those with PsA (65%) and without PsA (60%). The most common AEs were infections (27%); 4.2% of all patients reported serious AEs.
CONCLUSION:
Adalimumab treatment resulted in comprehensive, clinically relevant improvements from baseline PsA status, in skin, nails, quality of life, pain and pruritus. Despite having more severely affected disease and quality of life, patients with PsA did not respond to adalimumab significantly differently from patients without PsA.
AuthorsCarle Paul, Peter van de Kerkhof, Lluis Puig, Kristina Unnebrink, Orin Goldblum, Diamant Thaçi
JournalEuropean journal of dermatology : EJD (Eur J Dermatol) 2012 Nov-Dec Vol. 22 Issue 6 Pg. 762-9 ISSN: 1952-4013 [Electronic] France
PMID23178916 (Publication Type: Clinical Trial, Phase III, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
Chemical References
  • Anti-Inflammatory Agents
  • Antibodies, Monoclonal, Humanized
  • Adalimumab
Topics
  • Adalimumab
  • Adult
  • Anti-Inflammatory Agents (adverse effects, therapeutic use)
  • Antibodies, Monoclonal, Humanized (adverse effects, therapeutic use)
  • Arthralgia (drug therapy, etiology)
  • Arthritis, Psoriatic (complications, drug therapy)
  • Body Weight
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nail Diseases (drug therapy)
  • Pain Measurement
  • Pruritus (drug therapy, etiology)
  • Psoriasis (complications, drug therapy)
  • Quality of Life
  • Scalp Dermatoses (drug therapy)
  • Severity of Illness Index
  • Surveys and Questionnaires

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