Adalimumab for Treatment of Moderate to Severe Chronic Plaque Psoriasis of the Hands and Feet: Efficacy and Safety Results From REACH, a Randomized, Placebo-Controlled, Double-blind Trial | Dermatology | JAMA Dermatology | JAMA Network
[Skip to Navigation]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address 35.170.64.36. Please contact the publisher to request reinstatement.
1.
Menter  AGottlieb  AFeldman  SR  et al.  Guidelines of care for the management of psoriasis and psoriatic arthritis, section 1: overview of psoriasis and guidelines of care for the treatment of psoriasis with biologics.  J Am Acad Dermatol 2008;58 (5) 826- 85018423260Google ScholarCrossref
2.
Farley  EMasrour  S McKey  JMenter  A Palmoplantar psoriasis: a phenotypical and clinical review with introduction of a new quality-of-life assessment tool.  J Am Acad Dermatol 2009;60 (6) 1024- 103119467374Google ScholarCrossref
3.
Greaves  MWWeinstein  GD Treatment of psoriasis.  N Engl J Med 1995;332 (9) 581- 5887838193Google ScholarCrossref
4.
Kumar  BSaraswat  AKaur  I Palmoplantar lesions in psoriasis: a study of 3065 patients.  Acta Derm Venereol 2002;82 (3) 192- 19512353710Google ScholarCrossref
5.
Pettey  AABalkrishnan  RRapp  SRFleischer  ABFeldman  SR Patients with palmoplantar psoriasis have more physical disability and discomfort than patients with other forms of psoriasis: implications for clinical practice.  J Am Acad Dermatol 2003;49 (2) 271- 27512894076Google ScholarCrossref
6.
Adişen  ETekin  OGülekon  AGürer  MA A retrospective analysis of treatment responses of palmoplantar psoriasis in 114 patients.  J Eur Acad Dermatol Venereol 2009;23 (7) 814- 81919470063Google ScholarCrossref
7.
Cohen  DJScherschun  L Case reports: practical experience with efalizumab in hand and foot psoriasis.  J Drugs Dermatol 2007;6 (12) 1224- 123018189064Google Scholar
8.
Weinberg  JM Successful treatment of recalcitrant palmoplantar psoriasis with etanercept.  Cutis 2003;72 (5) 396- 39814655781Google Scholar
9.
Prossick  TABelsito  DV Alefacept in the treatment of recalcitrant palmoplantar and erythrodermic psoriasis.  Cutis 2006;78 (3) 178- 18017036660Google Scholar
10.
Grinblat  BScheinberg  M The enigmatic development of psoriasis and psoriasiform lesions during anti-TNF therapy: a review.  Semin Arthritis Rheum 2008;37 (4) 251- 25517640718Google ScholarCrossref
11.
Ko  JMGottlieb  ABKerbleski  JF Induction and exacerbation of psoriasis with TNF-blockade therapy: a review and analysis of 127 cases.  J Dermatolog Treat 2009;20 (2) 100- 10818923992Google ScholarCrossref
12.
Sfikakis  PPIliopoulos  AElezoglou  AKittas  CStratigos  A Psoriasis induced by anti-tumor necrosis factor therapy: a paradoxical adverse reaction.  Arthritis Rheum 2005;52 (8) 2513- 251816052599Google ScholarCrossref
13.
Takahashi  HHashimoto  YIshida-Yamamoto  AAshida  TKohgo  YIizuka  H Psoriasiform and pustular eruption induced by infliximab.  J Dermatol 2007;34 (7) 468- 47217584325Google ScholarCrossref
14.
Saurat  JHStingl  GDubertret  L  et al. CHAMPION Study Investigators, Efficacy and safety results from the randomized controlled comparative study of adalimumab vs. methotrexate vs. placebo in patients with psoriasis (CHAMPION).  Br J Dermatol 2008;158 (3) 558- 56618047523Google ScholarCrossref
15.
Menter  ATyring  SKGordon  K  et al.  Adalimumab therapy for moderate to severe psoriasis: a randomized, controlled phase III trial.  J Am Acad Dermatol 2008;58 (1) 106- 11517936411Google ScholarCrossref
16.
Luger  TABarker  JLambert  J  et al.  Sustained improvement in joint pain and nail symptoms with etanercept therapy in patients with moderate-to-severe psoriasis.  J Eur Acad Dermatol Venereol 2009;23 (8) 896- 90419453794Google ScholarCrossref
17.
Noiles  KVender  R Nail psoriasis and biologics.  J Cutan Med Surg 2009;13 (1) 1- 519298765Google Scholar
18.
Rigopoulos  DGregoriou  SLazaridou  E Treatment of nail psoriasis with adalimumab: an open label unblinded study [published online ahead of print October 6, 2009].  J Eur Acad Dermatol Venereol 2010;24 (5) 530- 53419807825Google ScholarCrossref
19.
Gupta  AKCooper  EA Psoriatic nail disease: quality of life and treatment.  J Cutan Med Surg 2009;13 ((suppl 2)) S102- S10619799826Google Scholar
20.
Lawry  M Biological therapy and nail psoriasis.  Dermatol Ther 2007;20 (1) 60- 6717403261Google ScholarCrossref
21.
Irla  NYawalkar  N Marked improvement in nail psoriasis during treatment with adalimumab.  Dermatology 2009;219 (4) 353- 35619851059Google ScholarCrossref
22.
Reich  K Approach to managing patients with nail psoriasis.  J Eur Acad Dermatol Venereol 2009;23 ((suppl 1)) 15- 2119686381Google ScholarCrossref
23.
Koo  JYMedLebwohl  MGedLee  CSed Mild-to-Moderate Psoriasis.  New York, NY Informa Healthcare USA, Inc2006;
24.
Leonardi  CLSobell  JMSofen  HKrell  J Phase IV study to evaluate the safety and efficacy of efalizumab for treatment of hand and foot psoriasis [abstract].  J Am Acad Dermatol 2007;56 (2) AB48Google ScholarCrossref
25.
Bissonnette  RPoulin  YBolduc  C  et al.  Etanercept in the treatment of palmoplantar pustulosis.  J Drugs Dermatol 2008;7 (10) 940- 94619112757Google Scholar
26.
Bissonnette  RPoulin  YGuenther  LLynde  CBolduc  CNigen  S Treatment of palmoplantar psoriasis with infliximab [abstract P1159]. Presented at: European Academy of Dermatology and Venereology Congress; October 7-11, 2009; Berlin, Germany
27.
Naldi  LGambini  D The clinical spectrum of psoriasis.  Clin Dermatol 2007;25 (6) 510- 51818021886Google ScholarCrossref
28.
Guinot  CLatreille  JPerrussel  MDoss  NDubertret  LFrench Psoriasis Group, Psoriasis: characterization of six different clinical phenotypes.  Exp Dermatol 2009;18 (8) 712- 71919366373Google ScholarCrossref
Study
April 11, 2011

Adalimumab for Treatment of Moderate to Severe Chronic Plaque Psoriasis of the Hands and Feet: Efficacy and Safety Results From REACH, a Randomized, Placebo-Controlled, Double-blind Trial

Author Affiliations

Author Affiliations: Central Dermatology, St Louis, Missouri (Dr Leonardi); Dalhousie University, Halifax, Nova Scotia, Canada (Dr Langley); Probity Medical Research, Waterloo, Ontario, Canada (Dr Papp); The University of Texas Health Center at Houston (Dr Tyring); Stratica Medical, Edmonton, Alberta, Canada (Dr Wasel); Dermatrials Research, Hamilton, Ontario, Canada (Dr Vender); Abbott GmbH & Co KG, Ludwigshafen, Germany (Dr Unnebrink); Abbott Laboratories, Abbott Park, Illinois (Drs Gupta and Valdecantos); and Psoriasis Treatment Center of Central New Jersey, East Windsor (Dr Bagel).

Arch Dermatol. 2011;147(4):429-436. doi:10.1001/archdermatol.2010.384
Abstract

Objective  To determine the efficacy, safety, and sustainability of response to adalimumab therapy for moderate to severe chronic plaque psoriasis involving hands and/or feet.

Design  Sixteen-week, randomized, double-blind, placebo-controlled evaluation of adalimumab therapy for moderate to severe chronic plaque psoriasis involving the hands and/or feet with a 12-week open-label extension (Randomized Controlled Evaluation of Adalimumab in Treatment of Chronic Plaque Psoriasis of the Hands and Feet [REACH]).

Setting  Multicenter outpatient study in the United States and Canada.

Participants  Patients with chronic plaque psoriasis on the hands and/or feet with a Physician's Global Assessment of hands and/or feet (hfPGA) score of “moderate” or above.

Intervention  Patients were randomized 2:1 to adalimumab (80 mg at week 0, then 40 mg every other week starting at week 1) or to matching placebo.

Main Outcome Measure  Percentage of patients achieving an hfPGA score of “clear” or “almost clear” at week 16.

Results  Seventy-two patients (adalimumab [n = 49];placebo [n = 23]) were evaluated. Baseline percentages of patients with moderate and severe hfPGA scores were 76% and 24%, respectively, for the adalimumab group and 74% and 26%, respectively, for the placebo group. At week 16, 31% and 4% of patients randomized to adalimumab and placebo, respectively, achieved an hfPGA score of clear or almost clear (P = .01). At week 28, 80% of the hfPGA clear or almost clear response was maintained from week 16 (25% for patients randomized to adalimumab). Adverse events in both groups were generally mild to moderate. In both periods combined, nasopharyngitis (27% and 13% for adalimumab- and placebo-treated patients, respectively) was most frequently reported.

Conclusion  Adalimumab is efficacious and well tolerated for treatment of chronic plaque psoriasis of hands and/or feet, with efficacy largely maintained to 28 weeks.

Trial Registration  clinicaltrials.gov Identifier: NCT00735787

×