Anti-TNFα therapy in the management of psoriasis: experience of a state referral center

BACKGROUND:Psoriasis is a chronic immune-mediated disease, characterized by increased levels of TNFα. Anti-TNFα agents have revolutionized the treatment of severe psoriasis by targeting an important molecule involved in its pathogenesis.OBJECTIVES:We report the experience of a state referral center...

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Main Authors: Laura Maria Andrade Silva (Author), Bruno de Oliveira Rocha (Author), Ana Cláudia Pinto Nobre (Author), Vitória Regina Pedreira de Almeida Rêgo (Author), Ivonise Follador (Author), Maria de Fátima Santos Paim de Oliveira (Author)
Format: Book
Published: Sociedade Brasileira de Dermatologia, 2014-06-01T00:00:00Z.
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Summary:BACKGROUND:Psoriasis is a chronic immune-mediated disease, characterized by increased levels of TNFα. Anti-TNFα agents have revolutionized the treatment of severe psoriasis by targeting an important molecule involved in its pathogenesis.OBJECTIVES:We report the experience of a state referral center that uses anti-TNFα agents for psoriasis.METHODS:We conducted a retrospective case series. Seventy-four out of 120 patients met the inclusion criteria. Clinical and laboratory data was analyzed using the chi-squared, Wicoxon and McNemar's tests. Associations were considered statistically significant when p-value<0.05.RESULTS:Forty-one subjects (55.40%) were male, with a mean age of 47.69±14.99 years. Median disease duration and pre-treatment PASI were 14.0 months (IQR 9.0-20.0), and 13.55 points (IQR 8.5-20.32). Sixty patients (81.10%) had arthropathic psoriasis. Forty-six subjects (62.20%) had comorbidities; the most frequent was dyslipidemia (25.70%). In 55.40% of patients, insufficient response to conventional therapies was the principal indication for using anti-TNFα drugs. Clinical improvement occurred in 93.20% of cases, and the post-treatment PASI median was 0.0 points (IQR 0.0-0.0). Adverse effects occurred in 6.80% of patients. Infections and elevation of transaminases occurred in 28.40% and 8.10% of cases, respectively.CONCLUSION:Post-treatment reduction in PASI was satisfactory and the occurrence of adverse effects was minor, mostly mild infusion effects and local reactions at drug administration sites.
Item Description:0365-0596
10.1590/abd1806-4841.20142613