[Efficacy of TNF-alpha antagonists for plaque-type psoriasis: a systematic review and graphical presentation].

Abstract

BACKGROUND:

Numerous studies investigating the efficacy of TNF-alpha antagonists in moderate-to-severe plaque-type psoriasis have been published. We present a graphic synthesis of efficacy data based on a systematic review of the published studies.

METHODS:

The Medline, Embase and Cochrane Library bibliographic databases were searched for studies based on the following selection criteria: 1. Original studies, 2. Using infliximab, etanercept or adalimumab as the sole systemic treatment for plaque-type cutaneous psoriasis, 3. Minimum follow-up of 10 weeks, 4. Use of the PASI75 index (improvement of at least 75% from baseline PASI score) as an endpoint. Twenty-one articles were selected and PASI75 scores and corresponding 95% confidence intervals were calculated at three, six and 12 months.

RESULTS:

At M3, success rates were about 80% with infliximab and adalimumab once-weekly, around 50% with etanercept 50mg twice-weekly and adalimumab fortnightly; and 30% with etanercept 25mg twice-weekly. Maintenance regimens after three months ensured success rates above 50% with all three treatments, although the long-term results were based on fewer studies.

CONCLUSION:

Our graphic synthesis and tolerance data for the three drugs should guide clinicians in their therapeutic choices in moderate-to-severe plaque-type psoriasis. Additional studies with better reporting of loss to follow-up are needed to better assess the long-term efficacy of these drugs.

• Authors: A Levy-Roy, R Porcher, A-L de Fonclare, P Morel, A Dupuy
• Journal: Annales de dermatologie et de venereologie (Ann Dermatol Venereol) Vol. 136 Issue 4 Pg. 315-22 (Apr 2009) ISSN: 0151-9638 [Print] France
• Vernacular Title: Efficacité des anti-TNF-alpha dans le psoriasis: revue systématique et représentation graphique.
• PMID: 19361697 (Publication Type: Journal Article, Review, Systematic Review)

Chemical References

• Anti-Inflammatory Agents
• Antibodies, Monoclonal
• Antibodies, Monoclonal, Humanized
• Immunoglobulin G
• Receptors, Tumor Necrosis Factor
• Tumor Necrosis Factor-alpha
• Infliximab
• Adalimumab
• Etanercept

Topics

• Adalimumab
• Anti-Inflammatory Agents (therapeutic use)
• Antibodies, Monoclonal (therapeutic use)
• Antibodies, Monoclonal, Humanized
• Drug Tolerance
• Etanercept
• Humans
• Immunoglobulin G (therapeutic use)
• Infliximab
• Psoriasis (drug therapy)
• Receptors, Tumor Necrosis Factor (therapeutic use)
• Treatment Outcome
• Tumor Necrosis Factor-alpha (antagonists & inhibitors)