Fonseca Eduardo, Iglesias Raquel, Paradela Sabela, Fernández-Torres Rosa M, Elberdín Laida
Department of Dermatology and.
J Dermatolog Treat. 2015 Jun;26(3):217-22. doi: 10.3109/09546634.2014.933166. Epub 2014 Jul 1.
Knowledge on the efficacy and safety of adalimumab in psoriasis patients switching from etanercept is scarce, especially on the influence that causes of etanercept discontinuation may have on adalimumab response.
To evaluate the response, adverse effects and factors that may influence the efficacy and safety of adalimumab in psoriasis patients who failed on etanercept therapy in a real-world setting.
Data from all moderate to severe plaque psoriasis patients who switched from etanercept to adalimumab were extracted from a registry of biological therapies of our department. Primary endpoint was the percentage of patients achieving PASI 50 at weeks 12, 24, and 52. Secondary endpoints were the percentages of patients achieving PASI 75 and PASI 90, patients who maintained PASI values <5 and <3, and the safety of adalimumab.
Of 35 patients who fulfilled the study criteria, 82.9% achieved PASI 50 at week 12, 74.3% at week 24, and 74.3% at week 52 on adalimumab treatment. Eleven of 16 primary and 11 of 17 secondary nonresponders to etanercept responded to adalimumab. There were no treatment discontinuations due to side effects.
Previous etanercept failure seems not influence the success and safety of adalimumab treatment in moderate to severe plaque psoriasis.
关于从依那西普转换为阿达木单抗治疗的银屑病患者的疗效和安全性的知识较少，尤其是依那西普停药原因可能对阿达木单抗反应产生的影响。
在真实世界环境中，评估阿达木单抗在依那西普治疗失败的银屑病患者中的反应、不良反应以及可能影响其疗效和安全性的因素。
从我们科室的生物治疗登记处提取所有从中度至重度斑块状银屑病患者从依那西普转换为阿达木单抗治疗的数据。主要终点是在第12周、24周和52周达到银屑病面积和严重程度指数（PASI）改善50%的患者百分比。次要终点是达到PASI改善75%和90%的患者百分比、维持PASI值<5和<3的患者以及阿达木单抗的安全性。
在符合研究标准的35例患者中，接受阿达木单抗治疗的患者在第12周时82.9%达到PASI 50，第24周时为74.3%，第52周时为74.3%。对依那西普治疗无反应的16例主要患者中的11例和17例次要患者中的11例对阿达木单抗有反应。没有因副作用而停药的情况。
先前依那西普治疗失败似乎不影响阿达木单抗治疗中度至重度斑块状银屑病的成功率和安全性。
