Study compares effectiveness of psoriasis treatments

Joel M. Gelfand, M.D., M.S.C.E., of the University of Pennsylvania Perelman School of Medicine in Philadelphia, and colleagues compared the effectiveness of biologic systemic therapy, nonbiologic systemic therapy, and phototherapy for treatment of psoriasis in a cohort of 713 patients with plaque psoriasis. Participants received monotherapy (methotrexate sodium, adalimumab, etanercept, or ustekinumab) or narrowband ultraviolet (UV)-B phototherapy. The primary outcome was clear or almost clear skin on the Physician Global Assessment Scale.

The researchers found that the proportion of patients who achieved the primary outcome was 23.8 percent with methotrexate, 47.7 percent with adalimumab, 34.2 percent with etanercept, 36.1 percent with ustekinumab, and 26.1 percent with narrowband UV-B. Patients receiving adalimumab, etanercept, and ustekinumab were significantly more likely to achieve the primary outcome than those receiving methotrexate, whereas there was no significant difference for those receiving phototherapy versus methotrexate. There was no response difference seen for quality of life.

"The effectiveness of psoriasis therapies in clinical practice may be lower than that reported in previous trials," the authors write. "These results provide novel benchmarks emphasizing the critical importance of studying effectiveness in real-world practice."

Several authors disclosed financial ties to the pharmaceutical and biotechnology industries.

More information: Arch Dermatol. 2012;148(4):487-494. doi:10.1001/archdermatol.2012.370

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