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Changes in C-reactive protein in patients with moderate-to-severe psoriasis switched to adalimumab therapy after suboptimal response to etanercept, methotrexate or phototherapy

Authors


  • Conflicts of interest

    • B.E.S. has been a consultant, investigator and/or an advisory board member for and received grant and/or honorarium support from AbbVie Inc., Amgen, Janssen, Pfizer, Novartis, Maruho and Celgene. Y.P. has been a consultant, investigator and/or an advisory board member for and received grant and/or honorarium support from AbbVie Inc., Amgen, Celgene, Janssen (Centocor), LeoPharma, Merck, Pfizer and Novartis. C.T. has been a consultant and speaker for Janssen, AbbVie Inc. and Amgen. Y.W. and D.A.W. are employees of AbbVie Inc. and own AbbVie Inc. stock. O.M.G. is a former employee of AbbVie and may own AbbVie stock.
  • Funding sources

    • The design, study conduct and financial support for the clinical trial was provided by AbbVie. AbbVie participated in the interpretation of data, review and approval of the manuscript. All authors had full access to all the data and the corresponding author takes responsibility for the integrity of the data and the accuracy of the data analysis. All authors were involved in drafting the manuscript and the decision to submit the manuscript for publication.

Abstract

Background

Psoriasis treatment can lower levels of the inflammatory biomarker C-reactive protein (CRP).

Objective

Evaluate CRP changes in patients with chronic plaque psoriasis who switched to adalimumab following suboptimal response to previous therapies.

Methods

C-reactive protein was measured at screening and after 16 weeks of adalimumab treatment following discontinuation of previous therapies: etanercept (substudy E; n = 77), methotrexate (substudy M; n = 38) or narrow-band ultraviolet B phototherapy (substudy P; n = 27). Associations of CRP with baseline characteristics and efficacy measures were evaluated.

Results

Median CRP change at the final visit was −0.3 mg/L overall and −0.4, −0.3 and −0.3 mg/L in substudies E, M and P respectively. Clinical response [Physician Global Assessment (PGA) ‘clear’ or ‘minimal’] was associated with greater CRP reductions vs. no response (PGA ‘mild’ or worse) overall (−0.4 vs. −0.3 mg/L) and in substudies E (−0.4 vs. −0.1 mg/L) and M (−0.5 vs. −0.2 mg/L), but not P (−0.1 vs. −0.4 mg/L). CRP decreases were, respectively, −0.4 and −0.3 mg/L in patients with and without a history of psoriatic arthritis and −0.1, −0.3 and −0.6 mg/L in normal weight, overweight and obese patients, respectively. CRP decreases after 16 weeks correlated positively (β = 0.004) with percentage change in Psoriasis Area and Severity Index (PASI;= 0.0398) and negatively (β = −0.360) with baseline CRP (< 0.0001).

Conclusion

C-reactive protein levels decreased during adalimumab therapy in patients with psoriasis who experienced suboptimal response to previous therapies. Clinical response was associated with greater CRP reductions overall and in substudies E and M, but not P. CRP reductions correlated with percentage reductions in PASI.

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