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Title: Psoriasis Patients Respond Similarly to Etanercept Therapy, Regardless of Treatment History: Presented at AAD

"Psoriasis Patients Respond Similarly to Etanercept Therapy, Regardless of Treatment History: Presented at AAD"

By Maggie Schwarz NEW YORK, NY -- August 5, 2004 -- Psoriatic patients with a history of prior systemic psoriasis therapy or phototherapy do not respond differently to etanercept treatment than those without such a history, according to a study reported here. To determine whether patients with a history of prior systemic psoriasis therapy or phototherapy would respond differently compared to those without such history, Bruce E. Strober, MD, PhD, associate director of dermatopharmacology, department of dermatology, New York University School of Medicine, New York, New York, and colleagues, conducted a study of 415 patients. Dr. Strober presented the results here July 31st at the American Academy of Dermatology Annual Summer Scientific Meeting. The researchers hypothesized that patients with a history of prior systemic psoriasis therapy or phototherapy may have different baseline demographics and disease characteristics, and may respond differently to etanercept treatment compared to those without such a history. Adult patients with active, stable plaque psoriasis involving at least 10% of body surface area were pooled from 3 studies totaling 415 patients and received etanercept 25 mg twice a week. They were stratified by prior experience with each of the following specific therapies: methotrexate, cyclosporine, acitretin, psolaren with ultraviolet A radiation (PUVA), and ultraviolet B (UVB) radiation. The researchers compared efficacy end points between patients with and without a history of specific therapies, and identified patient characteristics and efficacy outcomes that were significantly different between groups. Before starting the study, all systemic psoriasis therapy, drug therapies, and PUVA were withdrawn for at least 4 weeks, and UVB and topical agents were withdrawn for at least 2 weeks. Patients with a prior history of methotrexate, cyclosporine, acitretin, PUVA, or UVB therapy were found to have more severe psoriasis at baseline than patients without such history, but overall responses to etanercept therapy were similar. The proportion of patients who achieved a 50% improvement in Psoriasis Area and Severity Index (PASI) score was comparable at weeks 12 and 24 regardless of treatment history. The proportion of those who achieved a 75% improvement in PASI score was also comparable at weeks 12 and 24. Patients with a previous history of cyclosporine use had a lower mean percentage improvement in PASI score at week 12 (45.2% vs 56.5%, P =.045) than patients without such a history, but this different was no longer evident at week 24. It is possible that this finding was an artifact due to an insufficient washout of cyclosporine (baseline PASI scores artificially decreased). Dr. Strober concluded that, despite more severe disease at baseline, psoriasis patients with a history of systemic therapy or phototherapy achieved a comparable response to etanercept therapy compared to those without such a history. [Presentation title: Psoriasis Patients With Varying Treatment Histories Respond Similarly to Etanercept Therapy.]

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