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PACE study: real-life Psoriasis Area and Severity Index (PASI) 100 response with biological agents in moderate-severe
Carlo Giovanni Carrera1, Paolo Dapavo2, Piergiorgio Malagoli3
1a U.O. Dermatologia , Fondazione IRCCS Cà Granda - Ospedale Maggiore Policlinico , Milan , Italy.
Background:
Few studies have compared the use of different biologics in a real-life setting in plaque psoriasis patients.
Objective:
To compare the efficacy of biologics in psoriasis/psoriatic arthritis patients.
Methods:
Patients treated with adalimumab, etanercept and ustekinumab for at least 16 weeks were included. Achievement of Psoriasis Area Severity Index (PASI), PASI 90/100 response and time taken to achieve PASI 90/100 response were measured. Logistic regression was used to evaluate the effect of psoriasis localization on achievement of PASI 100 response.
Results:
Two hundred and fifty five patients were included. No difference was observed in PASI 90 response between etanercept and ustekinumab (65.5 vs. 55.4%), while adalimumab-treated patients had a higher response versusustekinumab (71.6 vs. 55.4%, p = .02). More patients achieved complete remission (PASI 100 response) with adalimumab versus etanercept (65.7 vs. 23%, p < .001) or ustekinumab (65.7 vs. 44.6%, p = .003). Adalimumab-treated patients achieving PASI 90 responded more quickly (by three and six months) versus ustekinumab or etanercept. PASI100 response was achieved in ∼43% of adalimumab and ustekinumab treated-patients by three months versus etanercept (14.3%), increasing to 92.5, 85.4 and 35.7%, respectively by six months. PASI100 response was associated with psoriasis nail involvement or genital psoriasis.
Conclusion:
In the real-life setting, adalimumab was the most effective biological agent for the treatment of plaque psoriasis.
