Real-world evidence in Australian psoriasis patients using Humira

[Fred]

This study assessed Humira (adalimumab) efficacy and drug survival in routine Australian clinical practice on patients with psoriasis.

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Background:
Although adalimumab has shown strong efficacy and safety in clinical trials, real-world evidence in Australian patients with moderate-to-severe chronic plaque psoriasis is limited. This study assessed adalimumab efficacy and drug survival in routine clinical practice, comparing outcomes with the Phase 3 REVEAL trial and its open-label extension.

Methods:
Data were extracted from the Australasian Psoriasis Registry for adults meeting Pharmaceutical Benefits Scheme criteria to be prescribed adalimumab for chronic plaque psoriasis. Baseline demographics, Psoriasis Area and Severity Index (PASI) scores and treatment history between June 2006 and March 2022 were analysed. Drug survival was evaluated using Kaplan–Meier and Cox regression.

Results:
A total of 306 patients were included; 59.8% had prior biologic exposure compared to 12.8% in REVEAL. The mean baseline PASI was 24.1 and at 3 months, 63.5% achieved PASI75 while 33.6% achieved PASI90. PASI90 responses remained stable through 3 years and exceeded REVEAL extension rates beyond 18 months. Median drug survival was 27.9 months; survival was 97.7%, 78.6%, 63.7% and 51.0% at 3, 9, 15 and 27 months, respectively. Male sex and achieving PASI ≤ 2 predicted longer drug survival.

Conclusions:
In Australian real-world practice, adalimumab demonstrated sustained effectiveness and drug survival in patients with chronic plaque psoriasis comparable to RCTs, despite higher baseline disease severity and greater prior biologic exposure.

Source: onlinelibrary.wiley.com

*Funding: F & E Bauer Foundation

[post=165]

[Raxyl]

This study assessed Humira (adalimumab) efficacy and drug survival in routine Australian clinical practice on patients with psoriasis.

Quote:

---

Background:
Although adalimumab has shown strong efficacy and safety in clinical trials, real-world evidence in Australian patients with moderate-to-severe chronic plaque psoriasis is limited. This study assessed adalimumab efficacy and drug survival in routine clinical practice, comparing outcomes with the Phase 3 REVEAL trial and its open-label extension.

Methods:
Data were extracted from the Australasian Psoriasis Registry for adults meeting Pharmaceutical Benefits Scheme criteria to be prescribed adalimumab for chronic plaque psoriasis. Baseline demographics, Psoriasis Area and Severity Index (PASI) scores and treatment history between June 2006 and March 2022 were analysed. Drug survival was evaluated using Kaplan–Meier and Cox regression.

Results:
A total of 306 patients were included; 59.8% had prior biologic exposure compared to 12.8% in REVEAL. The mean baseline PASI was 24.1 and at 3 months, 63.5% achieved PASI75 while 33.6% achieved PASI90. PASI90 responses remained stable through 3 years and exceeded REVEAL extension rates beyond 18 months. Median drug survival was 27.9 months; survival was 97.7%, 78.6%, 63.7% and 51.0% at 3, 9, 15 and 27 months, respectively. Male sex and achieving PASI ≤ 2 predicted longer drug survival.

Conclusions:
In Australian real-world practice, adalimumab demonstrated sustained effectiveness and drug survival in patients with chronic plaque psoriasis comparable to RCTs, despite higher baseline disease severity and greater prior biologic exposure.

Source: onlinelibrary.wiley.com

*Funding: F & E Bauer Foundation

[post=165]

My experience is that adalimumab only remained effective for me to the 4 month mark, at that point my psorisis rapidly worsened to the point it was worse than it had ever been. My derm transitioned me to secukinumab which rapidly reduced redness, thickness and scale to the point now seven years later I have no active plaques and only a low level of PSA.

While initially good, adalimumab did not turn out to be the longer term answer for me.

[Waine]

So far at the 3 month mark I'm still experiencing good response to physical symptoms of PsA on Humira. My initial blood tests showed a remarkable improvement in CRP and NLR. I'm due for follow up tests at the end of the month. 

Anecdotally I does seem that the pain response in my fingers is perhaps not as great as it initially was. But then my previous Doctors did allow poison  MTX to continue for years, even though my finger joints are very deformed. I am intrigued as to what the next blood tests reveal.

[Waine]

So far at the 3 month mark I'm still experiencing good response to physical symptoms of PsA on Humira. My initial blood tests showed a remarkable improvement in CRP and NLR. I'm due for follow up tests at the end of the month. 

Anecdotally I does seem that the pain response in my fingers is perhaps not as great as it initially was. But then my previous Doctors did allow poison  MTX to continue for years, even though my finger joints are very deformed. I am intrigued as to what the next blood tests reveal.

So I had to get blood work done for my upcoming surgery. These are the most interesting inflammation markers.

They are before starting Humira, 1 month after and now 3 months after

CRP - 11.9 -----1-------1.1
Neutrophils - 83.9-----60.6-----62.0
Lymphocytes - 8.5------23.7----22.1
NLR - 9.87----2.56----2.81