Outcome following a short period of adalimumab dose escalation as rescue therapy in psoriatic patients

Federico Bardazzi, Laura Bigi, Anna Campanati, Andrea Conti, Vito Di Lernia, Sergio Di Nuzzo, Shaniko Kaleci, Claudia Lasagni, Anna Maria Offidani, Alfredo Giacchetti, Massimiliano Nicolini, Alberta Bettacchi, Laura Rosa, Lidia Sacchelli

Research output: Contribution to journalArticlepeer-review


Background: Advances in biologic treatments have led to a new therapeutic frontier for moderate-to-severe psoriasis. Nevertheless, the efficacy of anti-TNFα decreases with time, requiring adjustments to maintain valuable Psoriasis Area and Severity Index (PASI) and Dermatology Life Quality Index (DLQI) responses. Objectives: To evaluate the efficacy and safety of adalimumab dose escalation (40 mg, subcutaneous, once a week for 24 weeks) in psoriatic adult patients with secondary loss of response (PASI ≥50 to ≤75 or PASI≥75 and DLQI ≥5). Materials and Methods: A multicentre, observational study involving different Italian third-level referral centres for psoriasis enrolled a total of 64 adult patients with moderate-to-severe psoriasis who were treated with adalimumab and experienced a secondary loss of response. Primary end-points were PASI< 75 or PASI ≥50 to ≤ 75 with DLQI ≤ 5, and the secondary end-point was the ability to maintain a therapeutic response, resuming adalimumab every other week. Results: At Week 16 and Week 24, 29/64 (45.3%) and 35/64 (54.6%) responded based on PASI, and mean DLQI was 4.9 and 4.09, respectively. At Week 36 and Week 48, 45.3% and 28.1% patients achieved the second end-point, respectively. No adverse events were recorded except for one patient with recurrent tonsillitis. Conclusion: Adalimumab escalation could be considered in cases with loss of response before switching to alternative biologic therapy.

Original languageEnglish
Pages (from-to)159-164
Number of pages6
JournalEuropean Journal of Dermatology
Issue number2
Publication statusPublished - Mar 1 2020


  • adalimumab
  • anti-TNFα
  • Dermatology Life Quality Index (DLQI)
  • psoriasis
  • Psoriasis Area and Severity Index (PASI)

ASJC Scopus subject areas

  • Dermatology


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