Drug focus: adalimumab in the treatment of moderate to severe psoriasis

Adalimumab is a fully human IgG1 monoclonal antibody that specifically binds to tumor necrosis factor (TNF)-alpha, and is administered by subcutaneous injection. The mechanism of action is based on both the neutralization of TNF-alpha bioactivity and the induction of apoptosis of TNF-expressing mononuclear cells. The drug is approved for the treatment of rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis (PsA), and recently also for the treatment of Crohn's disease. The effectiveness of adalimumab in psoriasis was previously suggested by the subset analysis of patients enrolled in PsA trials who were affected by concomitant psoriasis, and recently confirmed by a phase II trial and the preliminary results from phase III trials in moderate to severe psoriasis. These results demonstrate that adalimumab is effective in improving psoriasis and quality of life, with sustained effects over >/= 1-year treatment period. The safety data from psoriasis studies were similar to those of previous studies in other diseases. The risk of adverse events did not appear to increase with continuous long-term exposure to adalimumab.