Treatment of psoriasis with adalimumab

Background. Adalimumab is an anti-tumour necrosis factor agent of use in psoriatic arthritis. Aim. The objective of this study was to assess the efficacy and safety of adalimumab in patients with plaque psoriasis unresponsive to previous therapies. Methods. We present nine patients with psoriasis and psoriatic arthropathy treated with adalimumab, including a woman with a history of breast cancer and a man with hepatitis C virus-related liver disease. Results. After 12 weeks, 66.6%, 55.5% and 11.1% of the patients showed a Psoriasis Assessment and Severity Index response of 50%, 75% and 90%, respectively. After 20 weeks, these levels had increased to 75%, 62.5% and 37.5%, respectively. After 12 weeks, the Psoriasis Global Assessment (PGA) score was clear or almost clear in 33.3% of the patients. By week 20, this clearance rate had almost doubled (62.5%). In two patients, the treatment was prolonged for 52 weeks, with a sustained response. One patient presented nonspecific colitis and died as a result of in-hospital pneumonia; any implication of adalimumab in the death is not clear. No other serious adverse effects were observed. Conclusion. In this series adalimumab was found to be effective for psoriasis refractory to other treatments including infliximab and etanercept.