Adalimumab retreatment successfully restores clinical response and health‐related quality of life in patients with moderate to severe psoriasis who undergo therapy …

KB Gordon, AB Gottlieb, RG Langely… - Journal of the …, 2015 - Wiley Online Library
KB Gordon, AB Gottlieb, RG Langely, P Van De Kerkhof, KT Belasco, M Sundaram, M Okun…
Journal of the European Academy of Dermatology and Venereology, 2015Wiley Online Library
Background Published evaluations of skin disease signs and health‐related quality of life
(HRQ oL) upon therapy withdrawal and retreatment in psoriatic patients are limited to results
of drug withdrawal after short‐term treatment. Analyses are lacking that evaluate patients'
response to retreatment for patients treated successfully long‐term. Objective To study the
efficacy and safety of adalimumab in patients with long‐term clinical responses to
adalimumab who then discontinue therapy and are retreated with the same dosing regimen …
Background
Published evaluations of skin disease signs and health‐related quality of life (HRQoL) upon therapy withdrawal and retreatment in psoriatic patients are limited to results of drug withdrawal after short‐term treatment. Analyses are lacking that evaluate patients' response to retreatment for patients treated successfully long‐term.
Objective
To study the efficacy and safety of adalimumab in patients with long‐term clinical responses to adalimumab who then discontinue therapy and are retreated with the same dosing regimen as the initial course. Skin disease signs and patients' HRQoL are evaluated.
Methods
This post hoc analysis of an open‐label study (NCT00195676) included patients who had responded favourably to adalimumab during initial treatment (≥75% improvement in Psoriasis Area and Severity Index [PASI 75 response]) and had maintained good clinical response for an extended period (up to 252 weeks); patients had Physician's Global Assessment (PGA) 0 or 1 before treatment interruption. Following drug withdrawal (up to 40 weeks), all patients were retreated with adalimumab 80 mg initial dose, followed by 40 mg every‐other‐week for 16 weeks. PASI response and HRQoL were evaluated.
Results
Of the 133 patients in this analysis, 24 (18%) relapsed during therapy withdrawal. After 16 weeks of retreatment, 75% who relapsed and 89.9% who did not relapse, had a PASI 75 response; 89.5% achieved European Consensus Programme treatment goals after 16 weeks of retreatment. During drug withdrawal, HRQoL disproportionally worsened compared to skin disease signs; HROoL also considerably worsened for patients who did not relapse. Patients regained HRQoL upon retreatment with adalimumab. No new safety signals were identified in this study.
Conclusion
Retreatment with adalimumab was successful in improving psoriasis skin signs and HRQoL in this subgroup with initial and extended responses to therapy followed by relapse after treatment withdrawal. Patient's HRQoL should be considered, as it may substantially worsen during therapy interruption.
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