title: Analysis of body regions and components of PASI scores during adalimumab or methotrexate treatment for patients with moderate-to-severe psoriasis.
abstract: BACKGROUND
  The PASI score, the most common outcome measure in clinical trials of psoriasis treatment, is a non-linear scale that does not allow reliable assessment of subtle variations of its components (erythema, induration, and desquamation).
  
  
  OBJECTIVE
  Highlight treatment response patterns potentially hidden by PASI score's compounded weighted-average calculation.
  
  
  METHODS
  Patients with moderate-to-severe psoriasis enrolled in the phase-3, 16-week, randomized CHAMPION study, and received adalimumab, methotrexate, or placebo. PASI scores were assessed post hoc for improvement, by body region and component.
  
  
  RESULTS
  At Week 16, a significantly greater percentage of adalimumab-treated patients vs methotrexate- and placebo-treated patients, achieved PASI 75, PASI 90 and PASI 100 response in each body region and component. 55.7% of adalimumab-treated patients reached PASI 100 response in the head and neck region vs 16.7% overall. Two key components of PASI, induration and desquamation, were affected by treatment more than erythema, the third component. Adalimumab was particularly effective in complete resolution of induration (44.9% of patients) vs methotrexate (10.9%). For all PASI body regions and components, mean percent improvement in score at Weeks 2, 4, 8, 12, and 16 was significantly greater (P<0.05) for adalimumab treatment vs methotrexate or placebo.
  
  
  CONCLUSIONS
  Adalimumab therapy resulted in complete resolution of individual body regions in at least 30.6% up to 55.7% of patients in CHAMPION. This was more than twice that of methotrexate and placebo. PASI improvement by body region is a novel and an important patient-relevant outcome worthy of reporting in future studies.
authors.forename: Alexander A
authors.initials: AA
authors.lastname: Navarini
authors.forename: Yves
authors.initials: Y
authors.lastname: Poulin
authors.forename: Alan
authors.initials: A
authors.lastname: Menter
authors.forename: Yihua
authors.initials: Y
authors.lastname: Gu
authors.forename: Henrique D
authors.initials: HD
authors.lastname: Teixeira
mesh_terms: D000068879:Adalimumab; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D003879:Dermatologic Agents / Q000627:therapeutic use; D004311:Double-Blind Method; D006801:Humans; D008727:Methotrexate / Q000627:therapeutic use*; D011565:Psoriasis / Q000188:drug therapy* / Q000503:physiopathology; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents; D003879:Dermatologic Agents; D000068879:Adalimumab; D008727:Methotrexate