Efficacy of adalimumab across subgroups of patients with moderate-to-severe chronic plaque psoriasis of the hands and/or feet: post hoc analysis of REACH

Authors


  • Conflict of interest

      Conflict of interest
    • YP has received honoraria or grants from AbbVie, Amgen and Janssen for participation on advisory boards, as an investigator, and as a speaker; and has received grants from Celgene, Centocor, Eli Lilly, Incyte, Merck, Novartis, and Pfizer for participation as an investigator. JC has received honoraria or grants from AbbVie and Amgen for participation on advisory boards and as an investigator and speaker; and from Jansen, Celgene, Lilly, Pfizer and Merck as an investigator. RL has received honoraria or grants from AbbVie, Amgen, Celgene, Novartis, and Janssen for participation on advisory boards and as an investigator and speaker, and from Pfizer and Lilly for participation on advisory boards and as an investigator. KU and WV receive a salary and stock options as employees of AbbVie. OG received a salary as a former employee of AbbVie.
  • Funding sources

      Funding sources
    • AbbVie provided funding for this research and its publication, and had input in the design of the study, data collection, data analysis, manuscript preparation, reviews and approval, and publication decisions. All authors had access to the data and were involved with data analysis and interpretation, had input into the decision to submit the publication, contributed to content development, and reviewed and approved the publication.
  • Previous Presentations

      Previous Presentations
    • A portion of the data in this manuscript was presented as a poster at the 69th Annual Meeting of American Academy of Dermatology in New Orleans, Louisiana, February 4–8, 2011. (Langley RG, Crowley J, Unnebrink K, Goldblum O. Improvement in Nail Psoriasis is Associated With Improved Efficacy Outcomes in Hand and/or Foot Psoriasis in Adalimumab-treated Patients: Subanalysis of REACH. J Am Acad Dermatol. 2011;64[2, Supp 1]:AB7.)

Abstract

Background

The Randomized Controlled Evaluation of Adalimumab in Treatment of Chronic Plaque Psoriasis of the Hands and Feet (REACH) trial demonstrated that adalimumab was efficacious and well-tolerated for the treatment of hand and/or foot psoriasis through 28 weeks.

Objective

To evaluate the effects of patient baseline characteristics on efficacy of adalimumab treatment of hand and/or foot psoriasis.

Methods

Patients with moderate-to-severe chronic plaque psoriasis of the hands and/or feet were randomized 2 : 1 to adalimumab or placebo during the 16 week, double-blind period of REACH. Primary endpoint was percentage of patients achieving Physician's Global Assessment of the hands and/or feet of clear/almost clear at week 16. Post hoc analyses evaluated effects of baseline patient characteristics on the primary endpoint. Patients with nail psoriasis at baseline were assessed for association of Nail Psoriasis Severity Index (NAPSI) 50 response with efficacy outcomes at week 16.

Results

Seventy-two patients (49 adalimumab : 23 placebo) were analysed. Greater percentages of adalimumab-treated patients achieved the primary endpoint vs. placebo across all subgroups. Among 31 patients with nail psoriasis, a greater percentage of adalimumab-treated patients achieved NAPSI 50 (56.5%) vs. placebo (12.5%) at week 16. In adalimumab-treated patients, greater percentages of NAPSI 50 Responders vs. Non-responders achieved the primary endpoint, and had greater improvements in erythema, scaling, induration and fissuring, Dermatology Life Quality Index, and pain scores.

Conclusions

Adalimumab was efficacious in treating chronic plaque psoriasis of the hands and/or feet over 16 weeks, regardless of baseline characteristics. Marked improvement in nail psoriasis among adalimumab-treated patients correlated with significant improvements in skin disease and patient-reported outcomes.

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