Efficacy and safety of biologics in erythrodermic psoriasis: a multicentre, retrospective study.
Fiche publication
Date publication
août 2012
Auteurs
Membres identifiés du Cancéropôle Est :
Pr AUBIN François
Tous les auteurs :
Viguier M, Pages C, Aubin F, Delaporte E, Descamps V, Lok C, Beylot-Barry M, Seneschal J, Dubertret L, Morand JJ, Dreno B, Bachelez H
Lien Pubmed
Résumé
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 been scarcely reported. 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 (n=7), etanercept (n=6), ustekinumab (n=3) or efalizumab (n=2). A 75% improvement of BSA or Psoriais Area and Severity Index 12-14 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 seven of them, were observed. Biological treatment was discontinued for safety concern in 19% of cases. A given biologic was administered for up to 48 weeks in 34% of flares. CONCLUSIONS: 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 only one-third of patients still receiving the same drug after 1 year. The most significant safety concern consists of severe infections.
Référence
Br J Dermatol. 2012 Aug;167(2):417-23