Publication Date:
2012-04-03
Description:
Background: Even though efficacy of biologics has been extensively studied in psoriasis vulgaris, studies in erythrodermic psoriasis, the most severe form of the disease, have beenscarcelyreported. Objectives: To address the efficacy and safety of biologics in patients with erythrodermic psoriasis. Methods: A multicentre national retrospective study was performed using the French Psoriasis Group network. Patients showing psoriasis involving at least 90% of body surface area (BSA), and in whom severity of the disease had been evaluated before and after 3 and/or 6 months of treatment with biologics, were enrolled in the study. Results were expressed using intention to treat analysis. Results: We included 28 patients, representing 42 flares of erythrodermic psoriasis treated with infliximab (n=24), adalimumab (7), etanercept (6), ustekinumab (3) or efalizumab (2). A 75% improvement of BSA or PASI index 12 to 14 weeks after treatment onset was reached in 48% of flares treated with infliximab, in 50% of those treated with adalimumab and in 40% of those treated with etanercept. Twelve serious adverse events consisting of bacterial infection in 7 of them were observed. Biological treatment was discontinued for safety concern in 19% of cases. A given biologic was pursued up to 48 weeks in 34% of flares. Conclusion: Biologics show overall good short-term efficacy, but treatment switch due to lack of efficacy or side effects is frequently observed on a longer term, with one third of patients still receiving the drug after one year. The most significant safety concern consists of severe infections.
Print ISSN:
0007-0963
Electronic ISSN:
1365-2133
Topics:
Medicine
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