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Clobetasol propionate added to etanercept increased efficacy for patients with plaque psoriasis

Patients with moderate to severe plaque psoriasis who added short-term topical clobetasol propionate to etanercept showed additional clinical benefits at week 12 in a recent study.

Researchers evaluated 592 patients (mean age, 44.1 years; 66% men) who had a Psoriasis Area and Severity Index (PASI) score of at least10 and psoriasis-affected surface area of at least 10%. Patients randomly were assigned 50 mg etanercept twice weekly for 12 weeks followed by 50 mg once weekly for 12 weeks (n=297) or the same dosing schedule plus clobetasol propionate (CP) foam as needed to clear (no more than two up-to-2-week courses at weeks 11 to 12 and 23 to 24; n=295).

Significant differences were observed at week 12 for the primary endpoint of 75% improvement in PASI score (65.2% for the etanercept plus CP-treated cohort vs. 48.3% for etanercept patients; P<.001). Patients treated with etanercept/CP (29.7%) achieved a response of 90% improvement in PASI score more frequently than etanercept patients (19.4%; P=.009) The etanercept/CP patients reached a mean percentage improvement from baseline in PASI score of 76.5% vs. 68.2% for etanercept patients (P<.001). Static physician global assessment (sPGA) status of clear or almost clear was achieved by 63.1% of etanercept/CP patients vs. 47.3% in the etanercept group (P<.001). Etanercept/CP-treated patients also reported greater satisfaction at week 12 (P=.006).

At week 24, the difference between cohorts in response of 75% improvement in PASI score and sPGA status of clear or almost clear was not significant. Greater patient satisfaction with treatment (P=.001) and percentage improvement in PASI score (P=.031) were reported for etanercept/CP-treated patients vs. etanercept patients at that time point. Adverse events were comparable between cohorts.

“Addition of CP to etanercept yielded increased efficacy compared with etanercept alone at week 12 without an increase in treatment-related adverse events,” the researchers concluded.

Disclosure: See the study for a full list of relevant financial disclosures.