The effectiveness and safety of adalimumab in the treatment of non-reimbursed patients with mild-to-moderate psoriasis
Journal
Journal of the European Academy of Dermatology and Venereology
Journal Volume
26
Journal Issue
8
Pages
991-998
Date Issued
2012
Author(s)
Abstract
Background Few reports exist on the use of biologics for treating patients with mild-to-moderate psoriasis, especially for non-reimbursed patients. Objectives This study aimed to evaluate the safety and effectiveness of adalimumab in non-reimbursed patients with mild-to-moderate psoriasis. Methods Fifty one patients with mild-to-moderate psoriasis treated with adalimumab 40 mg every other week (eow) in a tertiary referral hospital in Taiwan between 2007 and 2010 were retrospectively reviewed. The clinical effectiveness of adalimumab was assessed using Subject's Global assessment (SGA) and Physician's Global Assessment (PGA), and the reasons for discontinuation were evaluated. Results After 12 weeks of adalimumab (40 mg subcutaneously eow without a loading dose) treatment, 66% and 74% of patients had SGA and PGA scores of at least marked improvement (greater than 50% improvement compared with baseline psoriasis), respectively, with 60% and 53% of patients achieving SGA and PGA scores of at least marked improvement after 24 weeks. Ten (71%) of 14 previous non-responders to etanercept achieved a SGA or PGA score of at least marked improvement after adalimumab treatment. Adalimumab was generally well tolerated, but four patients (7.8%) discontinued adalimumab due to adverse events. The mean time required for resumption of systemic anti-psoriatic therapy was 6 months (range, 1-12 months). Apart from financial limitations, the most common reasons for discontinuation were primary (23.5%) and secondary (13.7%) lack of efficacy. Conclusion In non-reimbursed mild-to-moderate psoriasis patients, SGA and PGA remained high for adalimumab. Effectiveness and remission duration were key factors affecting patients' willingness to pay for prolonged adalimumab treatment. ? 2011 The Authors. Journal of the European Academy of Dermatology and Venereology ? 2011 European Academy of Dermatology and Venereology.
SDGs
Other Subjects
adalimumab; alanine aminotransferase; efalizumab; etanercept; etretin; methotrexate; acne; adolescent; adult; aged; alanine aminotransferase blood level; alopecia areata; bacterial endocarditis; cellulitis; child; colon cancer; dermatology life quality index; disease severity; dizziness; drug efficacy; drug safety; drug substitution; drug tolerability; drug withdrawal; eczema; extrapulmonary tuberculosis; female; fever; flu like syndrome; folliculitis; gingivitis; headache; health care financing; herpes labialis; herpes zoster; human; hyperglycemia; injection site reaction; lymphoma; major clinical study; male; paronychia; physician global assessment; priority journal; pruritus; psoriasis; quality of life; reimbursement; remission; retrospective study; review; scoring system; side effect; stroke; subject global assessment; systemic therapy; treatment response; urticaria; weakness; Antibodies, Monoclonal, Humanized; Humans; Insurance Coverage; Psoriasis; Retrospective Studies; Severity of Illness Index; Taiwan
Type
review