J Zweegers1, B Roosenboom1, P C M van de Kerkhof1, J M P A van den Reek1, M E Otero1, S Atalay1, A L A Kuijpers2, M I A Koetsier3, W P Arnold4, M A Berends5, L Weppner-Parren6, M Bijen7, M D Njoo7, J M Mommers8, P P M van Lümig1, R J B Driessen1, W Kievit9, E M G J de Jong1,10. 1. Department of Dermatology, Radboud University Medical Center, Nijmegen, the Netherlands. 2. Maxima Medisch Centrum, Eindhoven/Veldhoven, the Netherlands. 3. Gelre Ziekenhuizen, Apeldoorn, the Netherlands. 4. Ziekenhuis Gelderse Vallei, Ede, the Netherlands. 5. Slingeland Ziekenhuis, Doetinchem, the Netherlands. 6. Jeroen Bosch Ziekenhuis, Den Bosch, the Netherlands. 7. Ziekenhuisgroep Twente, Almelo/Hengelo, the Netherlands. 8. St. Anna Ziekenhuis, Geldrop, the Netherlands. 9. Department of Epidemiology, Biostatistics and Health Technology Assessment, Radboud University Medical Center, Nijmegen, the Netherlands. 10. Radboud University Nijmegen, Nijmegen, the Netherlands.
Abstract
BACKGROUND: It is important to assess which patients with psoriasis are more likely to achieve high clinical responses on biologics. OBJECTIVES: To assess the number of treatment episodes (TEs) that achieve a 100% improvement in Psoriasis Area and Severity Index (PASI 100), PASI 90 or PASI ≤ 5 at week 24 of biological treatment, and which baseline patient characteristics predict treatment response. METHODS: Data from patients with psoriasis treated with adalimumab, etanercept, infliximab or ustekinumab were extracted from a prospective cohort. TEs with high clinical responses were described. Uni- and multivariate regression analyses were performed with the generalized estimating equation method to elucidate which baseline patient characteristics were predictors for PASI 90 and PASI ≤ 5 at week 24. RESULTS: In total, 454 TEs were extracted (159 adalimumab; 193 etanercept; 19 infliximab; 83 ustekinumab) from 326 patients. At week 24, in 3%, 15% and 59% of TEs, respectively, PASI 100, PASI 90 and PASI ≤ 5 was reached. In TEs without a PASI 100 or PASI 90 response, PASI ≤ 5 was still achieved in 58% and 52%, respectively. Baseline PASI ≥ 10 was a strong predictor for achieving PASI 90; baseline PASI < 10 and a lower baseline body mass index (BMI) were significant predictors for PASI ≤ 5 at week 24. CONCLUSIONS: A limited number of patients achieved PASI 100 or PASI 90 at 24 weeks of biological treatment. Including an absolute PASI score in the assessment of psoriasis severity is important. Baseline BMI was an important, modifiable predictor for a high response.
BACKGROUND: It is important to assess which patients with psoriasis are more likely to achieve high clinical responses on biologics. OBJECTIVES: To assess the number of treatment episodes (TEs) that achieve a 100% improvement in Psoriasis Area and Severity Index (PASI 100), PASI 90 or PASI ≤ 5 at week 24 of biological treatment, and which baseline patient characteristics predict treatment response. METHODS: Data from patients with psoriasis treated with adalimumab, etanercept, infliximab or ustekinumab were extracted from a prospective cohort. TEs with high clinical responses were described. Uni- and multivariate regression analyses were performed with the generalized estimating equation method to elucidate which baseline patient characteristics were predictors for PASI 90 and PASI ≤ 5 at week 24. RESULTS: In total, 454 TEs were extracted (159 adalimumab; 193 etanercept; 19 infliximab; 83 ustekinumab) from 326 patients. At week 24, in 3%, 15% and 59% of TEs, respectively, PASI 100, PASI 90 and PASI ≤ 5 was reached. In TEs without a PASI 100 or PASI 90 response, PASI ≤ 5 was still achieved in 58% and 52%, respectively. Baseline PASI ≥ 10 was a strong predictor for achieving PASI 90; baseline PASI < 10 and a lower baseline body mass index (BMI) were significant predictors for PASI ≤ 5 at week 24. CONCLUSIONS: A limited number of patients achieved PASI 100 or PASI 90 at 24 weeks of biological treatment. Including an absolute PASI score in the assessment of psoriasis severity is important. Baseline BMI was an important, modifiable predictor for a high response.
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Authors: Selma Atalay; Juul M P A van den Reek; Lieke J van Vugt; Marisol E Otero; Peter C M van de Kerkhof; Alfons A den Broeder; Wietske Kievit; Elke M G J de Jong Journal: BMC Dermatol Date: 2017-05-08
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Authors: J Seneschal; J-P Lacour; A Bewley; M Faurby; C Paul; G Pellacani; C De Simone; L Horne; A Sohrt; M Augustin; E Hammond; K Reich Journal: J Eur Acad Dermatol Venereol Date: 2020-06-08 Impact factor: 6.166