ABSTRACT
BACKGROUND AND OBJECTIVES: Etanercept is a dimeric fusion protein that binds to tumor necrosis factor and blocks inflammatory response. The purpose of this study was to assess the effects of etanercept and its maintenance in patients with severe and refractory psoriasis. PATIENTS AND METHOD: Twenty two patients with severe and refractory psoriasis in an open-label clinical trial were studied. Patients received etanercept 50 mg/week subcutaneously during 6 months. PASI (Psoriasis Assessment and Severity Index) was used to monitor disease activity in each month of treatment and in the follow up. Results at weeks 12 and 24 are shown. RESULTS: 96% of patients improved their PASI basal score early at week 12. This improvement was maintained until week 24. Etanercept was well tolerated without any significant adverse reaction. Time until relapse was 2.27 +/- 0.59 months (CI 95%: 1.94-2.60). CONCLUSION: Etanercept seems an effective therapy for severe and refractory psoriasis yet long-term dosing and safety studies of etanercept in psoriasic patients are needed.
Subject(s)
Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Immunoglobulin G/therapeutic use , Psoriasis/drug therapy , Receptors, Tumor Necrosis Factor/therapeutic use , Adult , Aged , Etanercept , Female , Humans , Male , Middle AgedABSTRACT
Fundamento y objetivos: Determinar el número y la proporción de pacientes con psoriasis extensa y refractaria que mejoraron tras la administración de etanercept, así como el tiempo medio de respuesta mantenida tras su retirada. Pacientes y método: Se incluyó en el estudio a 22 pacientes con psoriasis grave refractaria a otros tratamientos sistémicos a los que se les administraron 50 mg de etanercept a la semana durante 24 semanas. Presentamos los resultados en el Psoriasis Assessment and Severity Index (PASI) en las semanas 12 y 24, y la duración media de la mejoría. Resultados: Veintiún pacientes (96%) disminuyeron su puntuación en el PASI ya en la semana 12 respecto de la basal (p < 0,01), 9 (41%) alcanzaron el objetivo principal (PASI75) y 16 (73%) el objetivo secundario (PASI50). Dieciocho (82%) de los pacientes mejoraron su PASI respecto del basal en la semana 24 (p < 0,01). Catorce (63%) alcanzaron el PASI50 y 13 (59%) el PASI75. El tiempo medio (desviación estándar) libre de enfermedad hasta el rebrote tras el cese del tratamiento fue de 2,27 (0,59) (intervalo de confianza del 95%, 1,94-2,60). Conclusión: El etanercept parece una buena opción de tratamiento en los pacientes con psoriasis extensa y refractaria. El perfil de seguridad es adecuado y tiene una administración fácil
Background and objectives: Etanercept is a dimeric fusion protein that binds to tumor necrosis factor and blocks inflammatory response. The purpose of this study was to assess the effects of etanercept and its maintenance in patients with severe and refractory psoriasis. Patients and method: Twenty two patients with severe and refractory psoriasis in an open-label clinical trial were studied. Patients received etanercept 50 mg/week subcutaneously during 6 months. PASI (Psoriasis Assessment and Severity Index) was used to monitor disease activity in each month of treatment and in the follow up. Results at weeks 12 and 24 are shown. Results: 96% of patients improved their PASI basal score early at week 12. This improvement was mantained until week 24. Etanercept was well tolerated without any significant adverse reaction. Time until relapse was 2.27 ± 0.59 months (CI 95%: 1.94-2.60). Conclusion: Etanercept seems an effective therapy for severe and refractory psoriasis yet long-term dosing and safety studies of etanercept in psoriasic patients are needed
Subject(s)
Male , Female , Adult , Aged , Middle Aged , Humans , Psoriasis/drug therapy , Cytokines/physiology , Immunotherapy , Arthritis, Juvenile/drug therapy , Tumor Necrosis Factor-alpha/antagonists & inhibitorsABSTRACT
BACKGROUND AND OBJECTIVE: Infliximab is a chimeric monoclonal antibody that binds to tumor necrosis factor alpha and blocks the inflammatory response. The purpose of this study was to assess the effects of infliximab in patients with severe and refractory psoriasis. PATIENTS AND METHOD: Eleven patients with severe and refractory psoriasis were included in an open-label clinical trial. Patients received infliximab 5 mg/kg intravenously at weeks 0, 2, 6 and every 8 weeks. Psoriasis Assessment and Severity Index (PASI) and BSA (Body Surface Assessment) were used to monitor disease activity with each dose. Results at weeks 6 and 30 are shown. RESULTS: 90% of patients improved their PASI and BSA basal scores early at sixth week, achieving 63.6% (PASI75) and 72.7% (BSA50). This improvement was maintained until the 30th week (54.5% and 72.7%, respectively). Infliximab was well tolerated and there was no significant adverse reaction. CONCLUSIONS: Infliximab seems an effective therapy for severe and refractory psoriasis.
