title: A randomized trial of etanercept as monotherapy for psoriasis.
abstract: OBJECTIVE
  To determine safety and efficacy of monotherapy with etanercept.
  
  
  METHODS
  Randomized, double-blind, placebo-controlled, multicenter study.
  
  
  METHODS
  Outpatient, ambulatory; private practice and university dermatology research centers.
  
  
  METHODS
  Patients aged at least 18 years, with plaque psoriasis involving 10% or more of body surface area; 148 were screened and 112 were randomly assigned to treatment groups and received study drug.
  
  
  METHODS
  Patients received placebo or etanercept, 25 mg, subcutaneously twice a week for 24 weeks. Other psoriasis therapies were limited during the study.
  
  
  METHODS
  Safety measurements included tracking of adverse events and laboratory values. Efficacy was evaluated using the Psoriasis Area and Severity Index (PASI); the primary end point was a 75% improvement in PASI. Other efficacy measurements included patient and physician global assessments and quality-of-life measures.
  
  
  RESULTS
  After 12 weeks of treatment, 17 (30%) of the 57 etanercept-treated patients and 1 (2%) of the 55 placebo-treated patients had achieved PASI 75%, and after 24 weeks, 32 (56%) of etanercept-treated patients and 3 (5%) of placebo-treated patients had reached this level (P<.001 for both time points). By 24 weeks, psoriasis was clear or minimal by physician's global assessment in more than 50% of patients who received etanercept. Treatment failure (PASI response <50) occurred in 23% of patients at week 24. All other measures confirmed the efficacy of etanercept. Adverse events were similar among etanercept and placebo groups.
  
  
  CONCLUSIONS
  Etanercept monotherapy provided significant benefit to patients with psoriasis and had a favorable safety profile.
authors.affiliation: Clinical Research Center, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, 08901-0019, USA. gottliab@umdnj.edu
authors.forename: Alice B
authors.initials: AB
authors.lastname: Gottlieb
authors.forename: Robert T
authors.initials: RT
authors.lastname: Matheson
authors.forename: Nicholas
authors.initials: N
authors.lastname: Lowe
authors.forename: Gerald G
authors.initials: GG
authors.lastname: Krueger
authors.forename: Sewon
authors.initials: S
authors.lastname: Kang
authors.forename: Bernard S
authors.initials: BS
authors.lastname: Goffe
authors.forename: Anthony A
authors.initials: AA
authors.lastname: Gaspari
authors.forename: Mark
authors.initials: M
authors.lastname: Ling
authors.forename: Gerald D
authors.initials: GD
authors.lastname: Weinstein
authors.forename: Anjuli
authors.initials: A
authors.lastname: Nayak
authors.forename: Kenneth B
authors.initials: KB
authors.lastname: Gordon
authors.forename: Ralph
authors.initials: R
authors.lastname: Zitnik
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003196:Computer Graphics; D004311:Double-Blind Method; D000068800:Etanercept; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000627:therapeutic use*; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000188:drug therapy*; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use*; D012189:Retrospective Studies; D018709:Statistics, Nonparametric
chemical_list: D007074:Immunoglobulin G; D007166:Immunosuppressive Agents; D018124:Receptors, Tumor Necrosis Factor; D000068800:Etanercept