Long-term response to etanercept monotherapy in moderate to severe psoriasis: assessment in daily practice by the maintenance of low values of PASI and BSA

Introduction: Efficacy and safety profiles of etanercept have been proved in numerous clinical trials; however, efficacy is determined by means of PASI 75 and few studies consider the maintenance of long-term response. The aims of this study were to provide data on long-term response to etanercept monotherapy in daily practice and to propose a method to assess the efficacy based on the maintenance of low PASI and BSA. Methods: Patients with moderate-severe psoriasis treated with etanercept 50 mg weekly, achieving at least PASI 50 at 12 weeks, were included. Response was expressed as the percentage of patients maintaining PASI and BSA <= 5 and <= 3, respectively. Results: We included 76 patients (73.7% male and 26.3% female). PASI remained <= 5 in 71.1%, 61.3%, 54.4%, 38.3%, 8.6% and 5.9% of patients and <= 3 in 51.3%, 46.8%, 42.1%, 34%, 8.6% and 5.9% at 3, 12, 18, 24, 36 and 42 months. Conclusions: The maximum response is achieved between 6 and 9 months and remains stable in about 50% of cases until 18-24 months. Response maintains beyond 42 months in 6%. Maintenance of low PASI and BSA may be a most useful measure than the initial PASI reduction, which not always means enough improvement for the patient.