Efficacy and Safety of Adalimumab 40 mg Weekly Dosingin Patients with Resistant Psoriasis

Background: The recently updated dosing recommendation for adalimumab for psoriasis states that patients with inadequate response to adalimumab every other week (EOW) after 16 weeks may benefit from an increase in dosing frequency to 40 mg every week (EW).

Objectives: This study aims to investigatethe efficacy and safety experience of dose escalation of adalimumab to 40 mg weekly dosing patients with psoriasis with suboptimal response to 40 mg EOW dosing.

Methods: In this report 22 moderate-to-severe psoriasis patients treated with 40 mg adalimumab EW were evaluated retrospectively. Primary endpoints were safety and efficacy of treatment defined as statistically significant improvement of PASI and PGA in the 24 week of therapy.

Results: A total of 22 patients enrolled. Patients were under adalimumab 40 mg EOW therapy for a 16 weeks-1 year. We observed a rapid and significiant reduction of PASI and PGA scores in W4. By week 24, 95, 45% (n=21) of patients achieved ≥PASI 75, 72, 72% (n=16) of patients achieved ≥PASI 90 and 40, 9% of patients achieved PASI 100 response. The percentage of patients patients who achieved a PGA ‘Clear’ or ‘Almost Clear’ was 77, 27% (n=17) at W24. Dose escalation of adalimumab provided the achievement and long-term maintenance of clinical improvement in these patients. No side effects were observed during 40 mg EW adalimumab treatment.

Conclusions: Dose escalation could be a good approach for increasing efficacy in a subgroup of patients with an insufficient response to adalimumab, reducing symptoms of psoriasis.