DOI: http://dx.doi.org/10.18203/issn.2455-4529.IntJResDermatol20214443

Efficacy and safety of adalimumab in treating patients with moderate to severe plaque psoriasis: a retrospective study

Purnachandra Badabagni, Birudala Ramadevi, Jahnavi Sambangi

Abstract


Background: Psoriasis is a disease of systemic inflammation with multiple organ ramifications. It is a chronic, painful, non-communicable, immune-mediated, genetic disease-causing disfiguration and disability, for which there is no cure and with great negative impact on patients’ quality of life (QoL). Aim and objective was to assess the efficacy and safety of adalimumab (ADA) in moderate to severe plaque psoriasis.

Methods: A hospital based, analytical retrospective observational study was conducted among patients aged 18 years and above, irrespective of gender and who received adalimumab treatment for moderate-to-severe plaque psoriasis and attended the outpatient clinic of dermatology at a tertiary care hospital for a period of 12 months. Efficacy was evaluated in all patients at 4, 12 and at last visit by calculating PASI (psoriasis area and severity index) relative to pre-treatment visit (baseline 0 week) as there was no comparative group. Safety was assessed by recording of side effects if any. Data was entered in MS excel 2019 and statistical analysis was done using SPSS 23 demo version.

Results: The mean PASI score at 0 week was 24.4±3.26, this when compared to PASI score at 4 weeks (11.2±4.08), at 12 weeks (3.2±2.40), at 52 weeks (0.5±0.96) had shown an extreme statistically significant difference. Side effects reported were urticaria, diarrhea, upper respiratory tract infections.

Conclusions: Adalimumab was very effective for chronic psoriasis, when given at high loading dose followed by maintenance dose every other week with minimal side effects.

 

 


Keywords


Adalimumab, Biologics, Efficacy, Psoriasis, PASI, Safety

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References


Kamiya K, Karakawa M, Komine M, Kishimoto M, Sugai J, Ohtsuki M. Results of a retrospective study on the efficacy and safety of adalimumab 80 mg administrated every other week in patients with psoriasis at a single Japanese institution. J Dermatol. 2019;46(3):199-205.

Raychaudhuri SP, Raychaudhuri S, Bagchi D. Psoriasis and psoriatic arthritis: pathophysiology, therapeutic intervention, and complementary medicine. Angiogenesis and roles of adhesion molecules in psoriatic disease. Angiogenesis in Psoriasis. New Delhi: CRC Press; 2017.

Armesto S, Coto-Segura P, Mayorga J, Illaro A, Santos-Juanes J. Efficacy of adalimumab in the treatment of moderate-to-severe psoriasis: a retrospective study of 100 patients in daily practice. J Dermatol Treat. 2015;26(1):49-53.

AlQassimi S, AlBrashdi S, Galadari H, Hashim MJ. Global burden of psoriasis-comparison of regional and global epidemiology, 1990 to 2017. Int J Dermatol. 2020;59(5):566-71.

Kim WB, Jerome D, Yeung J. Diagnosis and management of psoriasis. Canadian Fam Phys. 2017;63(4):278-85.

Bedi TR. Clinical profile of psoriasis in North India. Indian J Dermatol Venereol Leprol. 1995;61:202-5.

Pariser D, Schenkel B, Carter C, Farahi K, Brown TM, Ellis CN, et al. A multicenter, non-interventional study to evaluate patient-reported experiences of living with psoriasis. J Dermatol Treat. 2016;27(1):19-26.

Reich K, Krüger K, Mössner R, Augustin M. Epidemiology and clinical pattern of psoriatic arthritis in Germany: a prospective interdisciplinary epidemiological study of 1511 patients with plaque‐type psoriasis. Br J Dermatol. 2009;160(5):1040-7.

Fujii RK, Mould JF, Tang B, Brandt H, Pomerantz D, Chapnick J, et al. PSY46 burden of disease in patients with diagnosed psoriasis in Brazil: results from 2011 National health and wellness survey (NHWS). Value Health. 2012;15(4):107.

Kimball AB, Jacobson C, Weiss S, Vreeland MG, Wu Y. The psychosocial burden of psoriasis. Am J Clinic Dermatol. 2005;6(6):383-92.

DeKorte J, Mombers FM, Bos JD, Sprangers MA. Quality of life in patients with psoriasis: a systematic literature review. J Investigat Dermatol. 2004;9(2):140-7.

Augustin M, Krüger K, Radtke MA, Schwippl I, Reich K. Disease severity, quality of life and health care in plaque-type psoriasis: a multicenter cross-sectional study in Germany. Dermatology. 2008;216(4):366-72.

Tang MM, Chang CC, Chan LC, Heng A. Quality of life and cost of illness in patients with psoriasis in Malaysia: a multicenter study. Int J Dermatol. 2013;52(3):314-22.

Feldman SR, Goffe B, Rice G, Mitchell M, Kaur M, Robertson D, et al. The challenge of managing psoriasis: unmet medical needs and stakeholder perspectives. Am Health Drug Benefit. 2016;9(9):504.

Nguyen CM, Beroukhim K, Danesh MJ, Babikian A, Koo J. The psychosocial impact of acne, vitiligo, and psoriasis: a review. Clinic Cosmet Investigation Dermatol. 2016;9:383.

Pariser D, Schenkel B, Carter C, Farahi K, Brown TM, Ellis CN, et al. A multicenter, non-interventional study to evaluate patient-reported experiences of living with psoriasis. J Dermatolog Treat. 2016;27(1):19-26.

Krueger G, Koo J, Lebwohl M, Menter A, Stern RS, Rolstad T. The impact of psoriasis on quality of life: results of a 1998 National psoriasis foundation patient-membership survey. Arch Dermatol. 2001;137(3):280-4.

Patel V, Horn EJ, Lobosco SJ, Fox KM, Stevens SR, Lebwohl M. Psoriasis treatment patterns: results of a cross-sectional survey of dermatologists. J Am Aca Dermatol. 2008;58(6):964-9.

Boehncke WH, Prinz J, Gottlieb AB. Biologic therapies for psoriasis. A systematic review. J Rheumatol. 2006;33(7):1447-51.

Wu JJ, Valdecantos WC. Adalimumab in chronic plaque psoriasis: a clinical guide. J Drug Dermatol. 2017;16(8):779-90.

Guenther L, Langley RG, Shear NH, Bissonnette R, Ho V, Lynde C, et al. Integrating biologic agents into management of moderate-to-severe psoriasis: a consensus of the Canadian Psoriasis Expert Panel. J Cutan Med Surg. 2004;8(5):321.

Chopra A, Mitra D, Agarwal R, Saraswat N, Chemburkar P, Sharma L. Real-life efficacy and safety of biosimilar adalimumab (ZRC-3197) in patients with plaque psoriasis: a tertiary care center experience. Indian Dermatol Online J. 2020;11(2):182.

Saurat JH, Stingl G, Dubertret L, Papp K, Langley RG, Ortonne JP, et al. Efficacy and safety results from the randomized controlled comparative study of adalimumab vs. methotrexate vs. placebo in patients with psoriasis (CHAMPION). Br J Dermatol. 2008;158(3):558-66.

DiLernia V, Bianchi L, Guerriero C, Stingeni L, Gisondi P, Filoni A, et al. Adalimumab in severe plaque psoriasis of childhood: a multi‐center, retrospective real‐life study up to 52 weeks observation. Dermatolog Ther. 2019;32(6):13091.

Menter A, Tyring SK, Gordon K, Kimball AB, Leonardi CL, Langley RG, et al. Adalimumab therapy for moderate to severe psoriasis: a randomized, controlled phase III trial. J Am Aca Dermatol. 2008;58(1):106-15.