P Fleming1, C Roubille2, V Richer3, T Starnino4, C McCourt5, A McFarlane6, S Siu7, J Kraft8, C Lynde8, J E Pope7, S Keeling6, J Dutz5, L Bessette9, R Bissonnette10, B Haraoui11, W P Gulliver12. 1. Division of Dermatology, University of Toronto, Toronto, ON, Canada. 2. Notre-Dame Hospital, University of Montreal Hospital Research Center (CRCHUM), Montreal, QC, Canada. 3. Department of Medicine, Dermatology Service, St-Luc Hospital, Montreal, Canada. 4. Sacré-Coeur Hospital of Montreal, University of Montreal, Montreal, QC, Canada. 5. Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC, Canada. 6. Division of Rheumatology, University of Alberta, Edmonton, AB, Canada. 7. Division of Rheumatology, Department of Medicine, Western University, St. Joseph's Health Care, London, ON, Canada. 8. Lynde Dermatology, Markham, ON, Canada. 9. Department of Medicine, Rheumatic Disease Unit, Centre Hospitalier Universitaire de Québec (pavillon CHUL), Quebec City, QC, Canada. 10. Innovaderm Research, Montreal, QC, Canada. 11. Department of Medicine, Rheumatic Disease Unit, Centre Hospitalier de l'Université de Montréal (CHUM) and Institut de Rhumatologie de Montréal, Montreal, QC, Canada. 12. Department of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada.
Abstract
BACKGROUND: Twenty to fifty percent of patients with psoriasis have depressive symptoms. OBJECTIVE: To describe the effects of biologics (tumour necrosis factor inhibitors [TNFi] or interleukin 12/23 inhibitors [IL-12/23i]) on depressive symptoms in patients with psoriasis. METHODS: Electronic databases were searched for randomized controlled trials (RCTs) examining the effects of biologics on depressive symptoms in adults with psoriasis. RESULTS: Of the 305 publications identified, three RCTs were included in a systematic review. In a trial evaluating ustekinumab, mean change in Hospital and Anxiety Depression Rating Scale at 24 weeks from baseline was 3.1 with ustekinumab (P < 0.001) vs. 0.21 with placebo (not significant). In a trial evaluating adalimumab, mean change in Zung Self-Rating Depression Scale at 12 weeks from baseline was -6.7 with adalimumab vs. -1.5 with placebo. In a trial evaluating etanercept, the between-group difference at 12 weeks in Beck Depression Inventory Scale was 1.8 (95% CI: 0.6, 2.90) in favour of etanercept over placebo. Limitations are that diagnostic criteria for depression were not used and scales and data from individual RCTs could not be combined. CONCLUSION: Adalimumab, etanercept and ustekinumab were associated with statistically significant reductions in depressive symptom scores using various scales in patients with moderate-to-severe psoriasis.
BACKGROUND: Twenty to fifty percent of patients with psoriasis have depressive symptoms. OBJECTIVE: To describe the effects of biologics (tumour necrosis factor inhibitors [TNFi] or interleukin 12/23 inhibitors [IL-12/23i]) on depressive symptoms in patients with psoriasis. METHODS: Electronic databases were searched for randomized controlled trials (RCTs) examining the effects of biologics on depressive symptoms in adults with psoriasis. RESULTS: Of the 305 publications identified, three RCTs were included in a systematic review. In a trial evaluating ustekinumab, mean change in Hospital and Anxiety Depression Rating Scale at 24 weeks from baseline was 3.1 with ustekinumab (P < 0.001) vs. 0.21 with placebo (not significant). In a trial evaluating adalimumab, mean change in Zung Self-Rating Depression Scale at 12 weeks from baseline was -6.7 with adalimumab vs. -1.5 with placebo. In a trial evaluating etanercept, the between-group difference at 12 weeks in Beck Depression Inventory Scale was 1.8 (95% CI: 0.6, 2.90) in favour of etanercept over placebo. Limitations are that diagnostic criteria for depression were not used and scales and data from individual RCTs could not be combined. CONCLUSION:Adalimumab, etanercept and ustekinumab were associated with statistically significant reductions in depressive symptom scores using various scales in patients with moderate-to-severe psoriasis.
Authors: H Engler; P Brendt; J Wischermann; A Wegner; R Röhling; T Schoemberg; U Meyer; R Gold; J Peters; S Benson; M Schedlowski Journal: Mol Psychiatry Date: 2017-01-31 Impact factor: 15.992