Treatment of Psoriasis with Different Dosage Regimens of Etanercept: Preliminary Results from the TαRanta Plastic Study Group

This pilot open-label study is aimed to assess clinical response in psoriasis patients receiving diverse dose regimens of etanercept, consisting of the same global cumulative dose of etanercept administered over different treatment periods. Eligible patients were assigned sequentially in a 1:1 ratio...

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Bibliographic Details
Published in:International journal of immunopathology and pharmacology 2010-07, Vol.23 (3), p.797-802
Main Authors: Cassano, N., Loconsole, F., Miracapillo, A., Travaglini, M., Digiuseppe, M.D., Congedo, M., Galluccio, A., Buquicchio, R., Mastrandrea, V., Filieri, M., Raho, G., Pezza, M., Vena, G.A.
Format: Article
Language:English
Subjects:
Adult
Aged
Dose-Response Relationship, Drug
Endpoint Determination
Etanercept
Female
Humans
Immunoglobulin G - administration & dosage
Immunoglobulin G - adverse effects
Immunoglobulin G - therapeutic use
Immunosuppressive Agents - administration & dosage
Immunosuppressive Agents - adverse effects
Immunosuppressive Agents - therapeutic use
Male
Middle Aged
Pilot Projects
Psoriasis - drug therapy
Psoriasis - pathology
Psoriasis - psychology
Receptors, Tumor Necrosis Factor - administration & dosage
Receptors, Tumor Necrosis Factor - therapeutic use
Skin - pathology
Young Adult
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Summary:This pilot open-label study is aimed to assess clinical response in psoriasis patients receiving diverse dose regimens of etanercept, consisting of the same global cumulative dose of etanercept administered over different treatment periods. Eligible patients were assigned sequentially in a 1:1 ratio to receive: etanercept 50 mg once weekly (QW) or 50 mg twice weekly (BIW) for 12 weeks. The final analysis included a total of 72 patients. At week 12 the Psoriasis Area and Severity Index (PASI) and Skindex-29 scores notably improved in both treatment arms, without significant differences between the two groups. The rate of patients attaining a PASI improvement ≥ 50% (PASI 50) at week 12 was 92% in the high-dose group. In these patients, etanercept dosage was decreased to 50 mg QW from week 13, with persistence of the PASI 50 response at week 24 in all cases. Thereafter, treatment was discontinued up to week 36 and almost 30% of patients experienced a gradual relapse of their psoriasis within this period. In the low-dose group, the PASI 50 response was observed in 75% of patients. These responders continued to be treated with etanercept 50 mg QW up to week 36 with persistence of the PASI 50 in 100% of cases at week 24 and 93% at week 36. In the low-dose regimen, 8 patients who did not respond at week 12 underwent dose escalation to 50 mg BIW for a further 12 weeks. At week 24, six of these patients gained the PASI 50 response, 4 of whom maintained the response up to week 36, after treatment discontinuation from week 24. Our results confirm that etanercept is very effective and well-tolerated in psoriasis and that the drug dosages and treatment duration may be modulated and adapted to clinical needs in a flexible way.
ISSN:0394-6320
2058-7384
DOI:10.1177/039463201002300314