Etanercept may have utility in psoriasis among patients with inadequate apremilast response

Among patients with psoriasis who showed an inadequate response to apremilast, etanercept was associated with strong response rates and patient-reported outcomes, according to a recently published study.

“Patients with moderate to severe psoriasis can have symptoms resulting in significant impact on patient-reported outcomes (PROs),” Jerry Bagel, MD, of the Psoriasis Treatment Center of Central New Jersey, and colleagues wrote. “The effect of etanercept in moderate to severe psoriasis patients who previously received apremilast was studied, including impact on PRO endpoints.”

The multicenter, open-label, single-arm, phase 4 estimation study enrolled 80 patients with moderate to severe disease who failed to mount an adequate response to Otezla (apremilast, Celgene).

Eligible participants received a subcutaneous 50 mg injection of Enbrel (etanercept, Amgen) twice a week for 12 weeks. This was followed by an additional 12 weeks of weekly 50 mg subcutaneous etanercept injections.

Results at 12 weeks showed improvements in Psoriasis Symptom Inventory (PSI) scores of 57% (SD = 30) for patients who achieved PASI 50 response, 67% (SD = 24) for those who reached PASI 75 and 83% (SD = 18) for those with PASI 90 response.

A similar pattern was reported for 24-week results, with 56% (SD = 40) improvement in PSI for patients who reached PASI 50 response, a 68% (SD = 29) improvement for those with PASI 75 response and an 80% (SD = 25) PSI improvement for patients reaching a PASI 90 response.

Regarding Dermatology Life Quality Index outcomes, week 12 findings showed a 69% improvement in DLQI for patients reaching a PASI 50 response, 68% for patients reaching PASI 75 and 90% for patients who achieved PASI 90 response. By 24 weeks, 68% of patients with a PASI 50 response showed improvement in DLQI, while 77% of those with PASI 75 response and 82% of those with PASI 90 response improved on DLQI.

Etanercept yielded “very satisfied” or “satisfied” treatment satisfaction marks at 12 weeks for 79% of patients who reached PASI 50 response, 81% of those with PASI 75 and 100% of those reaching PASI 90 response. By 24 weeks, 77% of patients with PASI 50 response were very satisfied or satisfied, while 86% of those with PASI 75 and 88% of those with PASI 90 reported these satisfaction levels.

“Patient-reported symptoms are important outcomes to consider in psoriasis management,” the researchers said. “[Etanercept] provided benefits in patients who did not have adequate response with [apremilast], with improvements seen in both psoriasis symptoms and patient impact.” – by Rob Volansky