Adalimumab Decreases C-Reactive Protein in Psoriasis Patients: Presented at EADV

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Title: Adalimumab Decreases C-Reactive Protein in Psoriasis Patients: Presented at EADV
URL: http://www.pslgroup.com/dg/22CDD6.htm
Doctor's Guide
September 19, 2008

By Jill Stein

PARIS -- September 19, 2008 -- Adalimumab treatment results in a significant reduction in levels of C-reactive protein (CRP) in patients with moderate to severe psoriasis, even in patients with the highest CRP levels, such as those with obesity or psoriatic arthritis, according to research presented here at the 17th European Academy of Dermatology and Venereology (EADV) Congress.

William Abramovits, MD, Dermatology Treatment and Research Center, Dallas, Texas, and colleagues evaluated CRP concentrations in patients with moderate to severe psoriasis, with and without psoriatic arthritis, prior to and following adalimumab treatment.

"C-reactive protein is increased in some patients with psoriasis, and is known to be a predictor of cardiovascular disease risk in the general population," Dr. Abramovits observed in a presentation on September 19.

All patients were enrolled in the Randomized Controlled Evaluation of Adalimumab Every Other Week Dosing in Moderate to Severe Psoriasis Trial (REVEAL) study. The 52-week, phase 3 trial was jointly conducted by investigators in Canada and the United States and examined adalimumab in 1,212 patients with moderate to severe chronic plaque psoriasis.

In the study, 814 patients were randomised to adalimumab and 398 to placebo. The adalimumab dose was 80 mg on week 0 and 40 mg every other week from week 1 to 15.

Baseline patient characteristics were similar between treatment groups.

At the start of the trial, 139 in the adalimumab group and 67 patients in the placebo group had elevated CRP levels. At the end of treatment, 64.6% and 33.3% of patients, respectively, had normalised CRP levels (P < .01).

In a subgroup analysis of 607 obese patients who had elevated CRP levels at baseline, results showed that 64.1% of adalimumab-treated patients with elevated CRP levels at baseline had normal CRP levels after 16 weeks of treatment versus 36.0% of placebo-treated patients (P < .01).

Among 337 patients with psoriatic arthritis, 71.9% of patients in the adalimumab group had normal CRP levels after 16 weeks of treatment compared with 42.9% of patients in the placebo cohort (P < .05).

Overall, the results demonstrated that adalimumab treatment normalised CRP concentrations in two-thirds of patients with an elevated CRP at baseline, Dr. Abramovits said. The benefit extended to patients with psoriatic arthritis or obesity, 2 common comorbidities of psoriasis.

Adalimumab is a fully human immunoglobulin G1 monoclonal antibody targeted against tumour necrosis factor, a cytokine that mediates the inflammatory process in psoriasis. The drug is approved for the treatment of psoriasis in the European Union, the United States, and other regions of the world.

Funding for the study was provided by Abbott.

[Presentation title: Effect of Adalimumab Treatment on C-Reactive Protein in Patients With Moderate to Severe Psoriasis: Abstract FP1307]

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