Baseline anti-dsDNA concentrations and previous treatments predict response to Adalimumab and Etanercept: a retrospective investigation of 146 psoriasis patients.

Abstract

BACKGROUND:

Adalimumab and Etanercept are TNF-α antagonists commonly used for treatment of moderate-to-severe psoriasis and psoriatic-arthritis. Reliable instruments to assist the selection of patients for a specific treatment in a real-world scenario are unavailable.

OBJECTIVE:

To identify patient characteristics and baseline laboratory parameters predicting response to Adalimumab- and Etanercept-treatment.

METHODS:

We report a retrospective observational study including 116 and 64 psoriasis-patients treated with Adalimumab and Etanercept, respectively, at a dermatological outpatient clinic of a university hospital. Thirty four patients contributed data to both biologics. First occurrence of either loss-of-response or serious-side-effects (LOR/SSE) was chosen as clinical endpoint and predictors were identified using Cox-regression.

RESULTS:

Baseline anti-double-stranded DNA (anti-dsDNA) concentrations, number of previous treatments with TNF-α antagonists in general and previous treatment with Etanercept in particular significantly predicted LOR/SSE to Adalimumab. The predictive effect of baseline anti-dsDNA was conserved in TNF-α antagonist naïve patients. Number of previous systemic treatments other than TNF-α antagonists significantly predicted LOR/SSE to Etanercept. Age and baseline psoriasis area and severity index (PASI) did not predict response to either biologic in a clinically significant manner.

CONCLUSION:

Our data suggests that treatment with Adalimumab may promise best results in psoriasis-patients with (A) low baseline anti-dsDNA concentrations, and (B) no previous TNF-α antagonist treatment. A clinically significant predictive effect of age and baseline PASI on response to Adalimumab and Etanercept is unlikely.

• Authors: Jochen H O Hoffmann, Christian Knoop, Alexander H Enk, Eva N Hadaschik
• Journal: Journal of dermatological science (J Dermatol Sci) Vol. 76 Issue 3 Pg. 180-5 (Dec 2014) ISSN: 1873-569X [Electronic] Netherlands
• PMID: 25306295 (Publication Type: Journal Article, Observational Study)
• Copyright: Copyright © 2014 Japanese Society for Investigative Dermatology. Published by Elsevier Ireland Ltd. All rights reserved.

Chemical References

• Antibodies, Antinuclear
• Antibodies, Monoclonal, Humanized
• Immunoglobulin G
• Immunosuppressive Agents
• Receptors, Tumor Necrosis Factor
• Tumor Necrosis Factor-alpha
• Adalimumab
• Etanercept

Topics

• Adalimumab
• Adult
• Antibodies, Antinuclear (blood)
• Antibodies, Monoclonal, Humanized (adverse effects, therapeutic use)
• Disease-Free Survival
• Etanercept
• Female
• Humans
• Immunoglobulin G (adverse effects, therapeutic use)
• Immunosuppressive Agents (adverse effects, therapeutic use)
• Kaplan-Meier Estimate
• Male
• Middle Aged
• Predictive Value of Tests
• Psoriasis (immunology, therapy)
• Receptors, Tumor Necrosis Factor (therapeutic use)
• Retrospective Studies
• Tumor Necrosis Factor-alpha (antagonists & inhibitors)