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Efficacy of switching between tumor necrosis factor-alfa inhibitors in psoriasis: results from the Italian Psocare registry.

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.

journal_name

J Am Acad Dermatol

journal_title

Journal of the American Academy of Dermatology

authors

Piaserico S,Cazzaniga S,Chimenti S,Giannetti A,Maccarone M,Picardo M,Peserico A,Naldi L,Psocare Study Group.

doi

10.1016/j.jaad.2013.10.019

subject

Has Abstract

pub_date

2014-02-01 00:00:00

pages

257-62.e3

issue

2

eissn

0190-9622

issn

1097-6787

pii

S0190-9622(13)01104-3

journal_volume

70

pub_type

杂志文章

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