Barrera Maria Victoria, Habicheyn Silvia, Mendiola Maria Victoria, Herrera Ceballos Enrique
Department of Dermatology, University Hospital Virgen de la Victoria, Campus Universitario Teatinos s/n, 29010 Malaga. Spain.
Eur J Dermatol. 2008 Nov-Dec;18(6):683-7. doi: 10.1684/ejd.2008.0541.
Etanercept is a tumor necrosis factor alfa (TNFalpha) antagonist whose efficacy and safety in the treatment of psoriasis have been proven in many clinical trials. Nevertheless, few studies evaluate the efficacy and safety of this therapy in patients after discontinuation and readministration. Our study aimed to evaluate the efficacy and safety of etanercept in daily clinical practice for the treatment of patients with moderate-to-severe plaque psoriasis. The study also examines the discontinuation and readministration of the treatment. We carried out a retrospective observational study that collected data on 66 patients with moderate-to-severe psoriasis treated with etanercept at 25 mg or 50 mg twice weekly (BIW) at intermittent intervals over a period of 3.4 years. The following variables were evaluated during each of the retreatment cycles: outcome of the psoriasis area severity index (PASI) [PASI 50, PASI 75, and PASI 90], joint pain, and nail involvement. A significant fall in the PASI during each treatment cycle was observed. During cycle 1, the evaluation of the PASI was significantly lower for patients who started treatment with 50 mg BIW at weeks 12 and 24, even after the dose was reduced at week 12. After each treatment cycle was completed, the mean time to relapse was 3 months. When treatment was reintroduced after a relapse, the response rate was similar to that observed in the initial cycle. Joint pain and nail involvement improved significantly in each of the treatment cycles. In no case did we observe a relapse after therapy was interrupted, conversion of the morphology of psoriasis, or severe adverse events. We conclude that clinical efficacy and safety are maintained over time, and in the successive retreatment cycles. The interest of our study lies in the fact that several cycles of reinitiation and discontinuation of treatment are examined.
依那西普是一种肿瘤坏死因子α（TNFα）拮抗剂，其在治疗银屑病方面的疗效和安全性已在多项临床试验中得到证实。然而，很少有研究评估这种疗法在停药和重新给药后对患者的疗效和安全性。我们的研究旨在评估依那西普在日常临床实践中治疗中度至重度斑块状银屑病患者的疗效和安全性。该研究还考察了治疗的停药和重新给药情况。我们进行了一项回顾性观察研究，收集了66例中度至重度银屑病患者的数据，这些患者在3.4年的时间里以每周两次、每次25mg或50mg的剂量间歇使用依那西普进行治疗。在每个再治疗周期中评估以下变量：银屑病面积和严重程度指数（PASI）的结果[PASI 50、PASI 75和PASI 90]、关节疼痛和指甲受累情况。在每个治疗周期中均观察到PASI显著下降。在第1周期，在第12周和第24周开始使用50mg每周两次治疗的患者，即使在第12周剂量降低后，PASI评估仍显著更低。每个治疗周期完成后，平均复发时间为3个月。复发后重新开始治疗时，缓解率与初始周期观察到的相似。在每个治疗周期中，关节疼痛和指甲受累情况均有显著改善。在任何情况下，我们均未观察到治疗中断后的复发、银屑病形态转变或严重不良事件。我们得出结论，随着时间推移以及在连续的再治疗周期中，临床疗效和安全性得以维持。我们研究的意义在于考察了几个治疗重新开始和停药的周期。
