Anti-TNFα therapy in the management of psoriasis: experience of a state referral center.

Autor: Silva LM; Universidade Federal da Bahia, Salvador, BA, Brazil., Rocha Bde O; Universidade Federal da Bahia, Salvador, BA, Brazil., Nobre AC; Universidade Federal da Bahia, Salvador, BA, Brazil., Rêgo VR; Universidade Federal da Bahia, Salvador, BA, Brazil., Follador I; Universidade Federal da Bahia, Salvador, BA, Brazil., Oliveira Mde F; Universidade Federal da Bahia, Salvador, BA, Brazil.
Jazyk: angličtina
Zdroj: Anais brasileiros de dermatologia [An Bras Dermatol] 2014 May-Jun; Vol. 89 (3), pp. 436-40.
DOI: 10.1590/abd1806-4841.20142613
Abstrakt: Background: Psoriasis is a chronic immune-mediated disease, characterized by increased levels of TNFα. Anti-TNFα agents have revolutionized the treatment of severe psoriasis by targeting an important molecule involved in its pathogenesis.
Objectives: We report the experience of a state referral center that uses anti-TNFα agents for psoriasis.
Methods: We conducted a retrospective case series. Seventy-four out of 120 patients met the inclusion criteria. Clinical and laboratory data was analyzed using the chi-squared, Wicoxon and McNemar's tests. Associations were considered statistically significant when p-value<0.05.
Results: Forty-one subjects (55.40%) were male, with a mean age of 47.69 ± 14.99 years. Median disease duration and pre-treatment PASI were 14.0 months (IQR 9.0-20.0), and 13.55 points (IQR 8.5-20.32). Sixty patients (81.10%) had arthropathic psoriasis. Forty-six subjects (62.20%) had comorbidities; the most frequent was dyslipidemia (25.70%). In 55.40% of patients, insufficient response to conventional therapies was the principal indication for using anti-TNFα drugs. Clinical improvement occurred in 93.20% of cases, and the post-treatment PASI median was 0.0 points (IQR 0.0-0.0). Adverse effects occurred in 6.80% of patients. Infections and elevation of transaminases occurred in 28.40% and 8.10% of cases, respectively.
Conclusion: Post-treatment reduction in PASI was satisfactory and the occurrence of adverse effects was minor, mostly mild infusion effects and local reactions at drug administration sites.
Databáze: MEDLINE
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