title: Etanercept for patients with psoriasis who did not respond or who lost their response to adalimumab or infliximab.
abstract: BACKGROUND
  There is a paucity of data on the use of etanercept in patients who have previously failed a different tumour necrosis factor (TNF) alpha antagonist.
  
  
  OBJECTIVE
  To study etanercept in patients who did not achieve a satisfactory response to adalimumab or who lost their response to adalimumab or infliximab and to explore the role of anti-adalimumab and anti-infliximab antibodies in etanercept response.
  
  
  METHODS
  Patients with psoriasis who did not achieve a satisfactory response to adalimumab or who lost their response to adalimumab or infliximab were included. All patients received etanercept 50 mg twice a week for 12 weeks followed by 50 mg once a week for 12 more weeks. Anti-infliximab and anti-adalimumab antibodies were measured at baseline. The primary objective was to study the efficacy of etanercept using the proportion of patients who achieved a physician global assessment (PGA) of 0 or 1.
  
  
  RESULTS
  A total of 81 patients were included. The proportion of patients who achieved a PGA of 0 or 1 after 24 weeks of etanercept was 20.0% (95% CI 4.8-35.2%) for patients who had an unsatisfactory response to adalimumab, 35.1% (95% CI 19.0-51.3%) and 35.7% (95% CI 7.0-64.4%) for patients who lost their response to adalimumab and infliximab respectively. The proportion of patients who achieved a PGA of 0 or 1 at week 24 was numerically higher for patients who had anti-adalimumab or anti-infliximab antibodies (36.5%) as compared to those without (17.2%; P = 0.08).
  
  
  CONCLUSIONS
  Etanercept can be effective in patients with psoriasis who failed a previous TNF alpha antagonist.
authors.affiliation: Innovaderm Research, Montreal, QC, Canada.
authors.forename: R
authors.initials: R
authors.lastname: Bissonnette
authors.affiliation: Innovaderm Research, Montreal, QC, Canada.
authors.forename: C
authors.initials: C
authors.lastname: Maari
authors.affiliation: Kirk Barber Research, Calgary, AB, Canada.
authors.forename: K
authors.initials: K
authors.lastname: Barber
authors.affiliation: Lynderm Research, Markham, ON, Canada.
authors.forename: C W
authors.initials: CW
authors.lastname: Lynde
authors.affiliation: Dermatrials Research, Hamilton, ON, Canada.
authors.forename: R
authors.initials: R
authors.lastname: Vender
mesh_terms: D000068879:Adalimumab / Q000276:immunology / Q000627:therapeutic use; D000906:Antibodies / Q000097:blood; D000068800:Etanercept / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D000069285:Infliximab / Q000276:immunology / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000097:blood / Q000188:drug therapy* / Q000276:immunology; D017211:Treatment Failure
chemical_list: D000906:Antibodies; D000069285:Infliximab; D000068879:Adalimumab; D000068800:Etanercept