Combination of adalimumab with traditional systemic antipsoriatic drugs – a report of 39 cases
Article first published online: 31 AUG 2012
© The Authors • Journal compilation © Blackwell Verlag GmbH, Berlin
JDDG: Journal der Deutschen Dermatologischen Gesellschaft
Volume 10, Issue 11, pages 821–837, November 2012
How to Cite
Philipp, S., Wilsmann-Theis, D., Weyergraf, A., Rotterdam, S., Frambach, Y., Gerdes, S. and Mössner, R. (2012), Combination of adalimumab with traditional systemic antipsoriatic drugs – a report of 39 cases. JDDG: Journal der Deutschen Dermatologischen Gesellschaft, 10: 821–837. doi: 10.1111/j.1610-0387.2012.07976.x
- Issue published online: 26 OCT 2012
- Article first published online: 31 AUG 2012
- Submitted: 23.12.2011 | Accepted: 16.5.2012
- psoriatic arthritis;
- combination therapy
Background: Monotherapy with TNF-α inhibitors does not always produce a sufficient response in psoriasis patients. Combinations of TNF-α antagonists such as adalimumab with systemic antipsoriatic therapies such as methotrexate are not approved for use in psoriasis, and the published data are scarce.
Patients and methods: The charts of 39 psoriasis patients from 6 dermatology departments were reviewed retrospectively. All patients were given adalimumbab with another systemic antipsoriatic drug.
Results: Combination therapy with methotrexate was most common (n = 32), followed by acitretin (n = 4) and cyclosporine (n = 3). Combination therapy with methotrexate lasted 10.8 ± 11.2 months (mean), with cyclosporine for 6.8 ± 3.3 months, and with acitretin 12.9 ± 12.4 months. Combinations were effective in the majority of patients: 30/39 (76.9 %) had a good (n = 9) or excellent (n = 21) response. Two patients had a moderate response and 7 patients had a poor response and were switched to another treatment. Overall, safety was very good. Eighteen patients experienced 24 adverse events; none was severe and/or required hospitalization. Of these, 10/24 adverse events were infections, most often infections of the upper respiratory tract (n = 5), bronchitis (n = 2), and influenza (n = 1).
Conclusions: Combinations of adalimumab with traditional systemic antipsoriatic treatments offer a promising method for managing severe or recalcitrant psoriasis. More data are needed to determine the long-term safety and efficacy of these combinations.