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Effectiveness of adalimumab dose escalation, combination therapy of adalimumab with methotrexate, or both in patients with psoriasis in daily practice.
MedLine Citation:
PMID:  23194389     Owner:  NLM     Status:  Publisher    
Abstract Abstract To increase effectiveness of standard adalimumab treatment 40mg every other week (EOW) for patients with psoriasis, dose escalation to 40mg every week or addition of methotrexate (MTX) are possible strategies. Methods Daily practice data about adalimumab treatment were extracted from a prospective observational cohort. We analyzed all patients with insufficient efficacy of adalimumab EOW who received (1) adalimumab dose escalation, (2) addition of MTX to adalimumab EOW or (3) both. Effectiveness was analyzed after 12 and 24 weeks using PASI50, PASI75 and mean differences in PASI. Results Forty-seven treatment episodes (TE) of adalimumab dose escalations, 11 of MTX addition and six combinations were analyzed. After a first episode of adalimumab dose escalation, 25% and 35% achieved PASI50 after 12 and 24 weeks respectively. After MTX introduction to adalimumb EOW, 9% and 18% achieved PASI50 after 12 and 24 weeks respectively. No related serious adverse events were reported. Conclusions Twenty-five percent of first TE with adalimumab dose escalation induced a PASI50 response after 12 weeks and 35% after 24 weeks. Addition of MTX to adalimumab EOW resulted in PASI50 in 9% after 12 weeks and 18% after 24 weeks. Defining patient-groups that will benefit from these interventions is important.
Juul van den Reek; Paula Pm van Lümig; Wietske Kievit; Jeffrey Zweegers; Peter Cm van de Kerkhof; Marieke Seyger; Elke de Jong
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-30
Journal Detail:
Title:  The Journal of dermatological treatment     Volume:  -     ISSN:  1471-1753     ISO Abbreviation:  J Dermatolog Treat     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-30     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8918133     Medline TA:  J Dermatolog Treat     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Department of Dermatology, Radboud University Nijmegen Medical Centre , The Netherlands.
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