Changes in C‐reactive protein in patients with moderate‐to‐severe psoriasis switched to adalimumab therapy after suboptimal response to etanercept, methotrexate or phototherapy. (15th January 2014)

• Record Type: Journal Article
• Authors: Strober, B.E.; Poulin, Y.; Teller, C.; Wang, Y.; Williams, D.A.; Goldblum, O.M.
• Is Part Of: Journal of the European Academy of Dermatology and Venereology. Volume 28:Number 12(2014:Dec.)
• Page Start: 1701
• Page End: 1706
• Publication Date: 2014-01-15
• Subjects: Dermatology -- Periodicals; Sexually transmitted diseases -- Periodicals; 616.5
• DOI: 10.1111/jdv.12372
• Languages: English
• ISSNs: 0926-9959

Abstract

<abstract abstract-type="main" id="jdv12372-abs-0001"> <title>Abstract</title> <sec id="jdv12372-sec-0001" sec-type="section"> <title>Background</title> <p>Psoriasis treatment can lower levels of the inflammatory biomarker C‐reactive protein (CRP).</p> </sec> <sec id="jdv12372-sec-0002" sec-type="section"> <title>Objective</title> <p>Evaluate CRP changes in patients with chronic plaque psoriasis who switched to adalimumab following suboptimal response to previous therapies.</p> </sec> <sec id="jdv12372-sec-0003" sec-type="section"> <title>Methods</title> <p>C‐reactive protein was measured at screening and after 16 weeks of adalimumab treatment following discontinuation of previous therapies: etanercept (substudy E; <italic>n</italic> = 77), methotrexate (substudy M; <italic>n</italic> = 38) or narrow‐band ultraviolet B phototherapy (substudy P; <italic>n</italic> = 27). Associations of CRP with baseline characteristics and efficacy measures were evaluated.</p> </sec> <sec id="jdv12372-sec-0004" sec-type="section"> <title>Results</title> <p>Median CRP change at the final visit was −0.3 mg/L overall and −0.4, −0.3 and −0.3 mg/L in substudies E, M and P respectively. Clinical response [Physician Global Assessment (PGA) 'clear' or 'minimal'] was associated with greater CRP reductions vs. no response (PGA 'mild' or worse) overall (−0.4 vs. −0.3 mg/L) and in substudies E (−0.4 vs. −0.1 mg/L) and M (−0.5 vs. −0.2 mg/L), but not P (−0.1 vs. −0.4 mg/L). CRP decreases were, respectively, −0.4 and −0.3 mg/L in patients with and without a history of psoriatic arthritis and −0.1, −0.3 and −0.6 mg/L in normal weight, overweight and obese patients, respectively. CRP decreases after 16 weeks correlated positively (β = 0.004) with percentage change in Psoriasis Area and Severity Index (PASI;<italic> P </italic>= 0.0398) and negatively (β = −0.360) with baseline CRP (<italic>P </italic>< 0.0001).</p> </sec> <sec id="jdv12372-sec-0005" sec-type="section"> <title>Conclusion</title> <p>C‐reactive protein levels decreased during adalimumab therapy in patients with psoriasis who experienced suboptimal response to previous therapies. Clinical response was associated with greater CRP reductions overall and in substudies E and M, but not P. CRP reductions correlated with percentage reductions in PASI.</p> </sec> </abstract>