Background: Studies analyzing the efficacy and safety of interrupted psoriasis therapy with biologic drugs have not reported clear benefits in routine clinical practice.
Objectives: To identify differences in the disease control of psoriasis patients undergoing continuous or interrupted therapy with adalimumab or etanercept.
Methods: This retrospective 3-year cohort study (interrupted vs. continuous therapy) involved 77 patients (47 adalimumab, 30 etanercept) who were managed under clinical practice conditions. The proportion of episodes with a Physician Global Assessment (PGA) ≥ 3 during the follow-up in each study cohort was the primary effectiveness endpoint. The relative risk of PGA ≥ 3 episodes in the interrupted therapy cohort was analyzed.
Results: Twenty-one patients receiving adalimumab were included in the interrupted therapy cohort (44.7 %), and 26 were included in the continuous therapy cohort (55.3 %). In the group of etanercept, 21 patients received continuous treatment (70.0 %), and nine patients started at least one interruption period (30.0 %). The proportion of PGA ≥ 3 episodes in continuous and interrupted groups were 19.2 % vs. 33.3 % for adalimumab patients (p = 0.27), and 42.9 % vs. 55.6 % in patients treated with etanercept (p = 0.52). The relative risk of PGA ≥ 3 episodes with interrupted therapy was 1.73 (95 % confidence interval 0.64-4.68; p = 0.27), and 1.30 (95 % confidence interval 0.60-2.79; p = 0.52) in the adalimumab and etanercept groups, respectively.
Conclusion: In routine clinical practice, interrupted therapy with adalimumab or etanercept can provide adequate disease control for a subgroup of patients with excellent response to biologic drugs.