Efficacy and safety of biologics in erythrodermic psoriasis: a multicentre, retrospective study.
Br J Dermatol
; 167(2): 417-23, 2012 Aug.
Article
in En
| MEDLINE
| ID: mdl-22413927
ABSTRACT
BACKGROUND:
Even though efficacy of biologics has been extensively studied in psoriasis vulgaris, studies in erythrodermic psoriasis, the most severe form of the disease, have been scarcely reported.OBJECTIVES:
To address the efficacy and safety of biologics in patients with erythrodermic psoriasis.METHODS:
A multicentre national retrospective study was performed using the French Psoriasis Group network. Patients showing psoriasis involving at least 90% of body surface area (BSA), and in whom severity of the disease had been evaluated before and after 3 and/or 6 months of treatment with biologics, were enrolled in the study. Results were expressed using intention-to-treat analysis.RESULTS:
We included 28 patients, representing 42 flares of erythrodermic psoriasis treated with infliximab (n=24), adalimumab (n=7), etanercept (n=6), ustekinumab (n=3) or efalizumab (n=2). A 75% improvement of BSA or Psoriais Area and Severity Index 12-14 weeks after treatment onset was reached in 48% of flares treated with infliximab, in 50% of those treated with adalimumab and in 40% of those treated with etanercept. Twelve serious adverse events, consisting of bacterial infection in seven of them, were observed. Biological treatment was discontinued for safety concern in 19% of cases. A given biologic was administered for up to 48 weeks in 34% of flares.CONCLUSIONS:
Biologics show overall good short-term efficacy, but treatment switch due to lack of efficacy or side-effects is frequently observed on a longer term, with only one-third of patients still receiving the same drug after 1 year. The most significant safety concern consists of severe infections.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Psoriasis
/
Biological Products
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Dermatitis, Exfoliative
/
Dermatologic Agents
Type of study:
Observational_studies
Limits:
Adolescent
/
Adult
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Aged
/
Child
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Child, preschool
/
Female
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Humans
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Male
/
Middle aged
Language:
En
Journal:
Br J Dermatol
Year:
2012
Document type:
Article
Affiliation country:
France