Baseline anti-dsDNA concentrations and previous treatments predict response to Adalimumab and Etanercept: a retrospective investigation of 146 psoriasis patients

Background - Adalimumab and Etanercept are TNF-α antagonists commonly used for treatment of moderate-to-severe psoriasis and psoriatic-arthritis. Reliable instruments to assist the selection of patients for a specific treatment in a real-world scenario are unavailable. - Objective - To identify pati...

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Hauptverfasser: Hoffmann, Jochen (VerfasserIn) , Knoop, Christian (VerfasserIn) , Enk, Alexander (VerfasserIn) , Hadaschik, Eva (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 28 September 2014
In: Journal of dermatological science
Year: 2014, Jahrgang: 76, Heft: 3, Pages: 180-185
ISSN:1873-569X
DOI:10.1016/j.jdermsci.2014.09.003
Online-Zugang:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.jdermsci.2014.09.003
Verlag, lizenzpflichtig, Volltext: http://www.sciencedirect.com/science/article/pii/S0923181114002205
Volltext
Verfasserangaben:Jochen H.O. Hoffmann, Christian Knoop, Alexander H. Enk, Eva N. Hadaschik

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520 |a Background - Adalimumab and Etanercept are TNF-α antagonists commonly used for treatment of moderate-to-severe psoriasis and psoriatic-arthritis. Reliable instruments to assist the selection of patients for a specific treatment in a real-world scenario are unavailable. - Objective - To identify patient characteristics and baseline laboratory parameters predicting response to Adalimumab- and Etanercept-treatment. - Methods - We report a retrospective observational study including 116 and 64 psoriasis-patients treated with Adalimumab and Etanercept, respectively, at a dermatological outpatient clinic of a university hospital. Thirty four patients contributed data to both biologics. First occurrence of either loss-of-response or serious-side-effects (LOR/SSE) was chosen as clinical endpoint and predictors were identified using Cox-regression. - Results - Baseline anti-double-stranded DNA (anti-dsDNA) concentrations, number of previous treatments with TNF-α antagonists in general and previous treatment with Etanercept in particular significantly predicted LOR/SSE to Adalimumab. The predictive effect of baseline anti-dsDNA was conserved in TNF-α antagonist naïve patients. Number of previous systemic treatments other than TNF-α antagonists significantly predicted LOR/SSE to Etanercept. Age and baseline psoriasis area and severity index (PASI) did not predict response to either biologic in a clinically significant manner. - Conclusion - Our data suggests that treatment with Adalimumab may promise best results in psoriasis-patients with (A) low baseline anti-dsDNA concentrations, and (B) no previous TNF-α antagonist treatment. A clinically significant predictive effect of age and baseline PASI on response to Adalimumab and Etanercept is unlikely. 
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