Efficacy of switching between tumor necrosis factor-alfa inhibitors in psoriasis: Results from the Italian Psocare Registry - 16/01/14
Psocare Study Group*
Abstract |
Background |
Some studies have shown that switching patients from one tumor necrosis factor (TNF)-alfa inhibitor to another may be beneficial when they have an inadequate response or an adverse event.
Objective |
We sought to assess the variables predicting the efficacy of the second TNF-alfa inhibitor in patients discontinuing the first TNF-alfa inhibitor.
Methods |
Data from all 5423 consecutive patients starting TNF-alfa inhibitor therapy for psoriasis between September 2005 and September 2010 who were included in the Italian Psocare registry were analyzed.
Results |
In 105 patients who switched to a second TNF-alfa inhibitor who had complete follow-up data, 75% improvement in the Psoriasis Area Severity Index score (PASI 75) was reached by 29% after 16 weeks and by 45.6% after 24 weeks. Patients who switched because of secondary loss of efficacy (loss of initial PASI 75 response) or adverse events/intolerance were more likely to reach PASI 75 than those who switched as a result of primary inefficacy (PASI 75 never achieved) (hazard ratio 2.7, 95% confidence interval 1.3-5.5 vs hazard ratio 2.0, 95% confidence interval 1.0-3.9 and 1, respectively).
Limitations |
There was a small number of patients with complete follow-up data.
Conclusion |
PASI 75 response in patients who switched from one anti–TNF-alfa agent to another was significantly reduced in patients who showed primary inefficacy of the first anti–TNF-alfa.
Le texte complet de cet article est disponible en PDF.Key words : biologics, efficacy, primary inefficacy, psoriasis, secondary loss of efficacy, switching, tumor necrosis factor-alfa inhibitors
Abbreviations used : PASI, PASI 75, TNF
Plan
Funding sources: None. |
|
Disclosure: Dr Piaserico received fees for services on advisory panels and lectures from Abbott, Galderma, Janssen-Cilag, Leo Pharma, MSD, Novartis, and Pfizer. Dr Chimenti served and/or is serving as a consultant for Abbott, Merck, Pfizer, and Janssen-Cilag. Dr Giannetti served as a consultant for Abbott, Merck, and Pfizer. Dr Picardo served as a consultant for Abbott and Pfizer. Dr Peserico served and/or is serving as a consultant or received fees for services on advisory panels and lectures from Abbott, Almirall, Galderma, Janssen-Cilag, Leo Pharma, MSD, Novartis, and Pfizer. Dr Naldi is a member of the Global Steering Committee of the Psolar Registry supported by Centocor and serves as a consultant for Janssen-Cilag. Dr Cazzaniga and Ms Maccarone have no conflicts of interest to declare. |
Vol 70 - N° 2
P. 257 - février 2014 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?