Efficacy of Adalimumab for Plaque Psoriasis: Experience with 28 Patients

Psoriasis is a common, chronic inflammatory skin disease with arthritis that may occur in a percentage of patients that varies between 5% and 42%. Many systemic agents as cyclosporine, methotrexate, acitretin, and photochemotherapy have been used for the treatment of patients affected by moderate-to-severe plaque psoriasis although they present side effects (ie, cumulative organ toxicity and lack of efficacy over time) that limit long-term use. Significant therapeutical improvement has been obtained introducing biological therapies, designed to modify and regulate immunological processes by targeting specific molecules involved in the immunopathogenesis of psoriasis. Adalimumab is a fully human recombinant antibody against tumor necrosis factor-alpha (TNF-alpha). To date, there is not much data available on the efficacy and safety of adalimumab in patients affected by moderate-to-severe plaque psoriasis. The authors report our first experience on the efficacy and safety of adalimumab in monotherapy at a dose of 40 mg every-other-week for the treatment of plaque psoriasis in patients with or without arthritis. Twenty-eight patients were treated for a period of 48 months. It was observed an improvement of the psoriasis condition as well as of patients’ quality of life and mood state.