PACE study: real-life Psoriasis Area and Severity Index (PASI) 100 response with biological agents in moderate-severe psoriasis

Carlo Giovanni Carrera, Paolo Dapavo, Piergiorgio Malagoli, Luigi Naldi, Luisa Arancio, Francesca Gaiani, Colin Gerard Egan, Marco Di Mercurio, Angelo Cattaneo

Research output: Contribution to journalArticlepeer-review


Background: Few studies have compared the use of different biologics in a real-life setting in plaque psoriasis patients. Objective: To compare the efficacy of biologics in psoriasis/psoriatic arthritis patients. Methods: Patients treated with adalimumab, etanercept and ustekinumab for at least 16 weeks were included. Achievement of Psoriasis Area Severity Index (PASI), PASI 90/100 response and time taken to achieve PASI 90/100 response were measured. Logistic regression was used to evaluate the effect of psoriasis localization on achievement of PASI 100 response. Results: Two hundred and fifty five patients were included. No difference was observed in PASI 90 response between etanercept and ustekinumab (65.5 vs. 55.4%), while adalimumab-treated patients had a higher response versusustekinumab (71.6 vs. 55.4%, p = .02). More patients achieved complete remission (PASI 100 response) with adalimumab versus etanercept (65.7 vs. 23%, p < .001) or ustekinumab (65.7 vs. 44.6%, p = .003). Adalimumab-treated patients achieving PASI 90 responded more quickly (by three and six months) versus ustekinumab or etanercept. PASI100 response was achieved in ∼43% of adalimumab and ustekinumab treated-patients by three months versus etanercept (14.3%), increasing to 92.5, 85.4 and 35.7%, respectively by six months. PASI100 response was associated with psoriasis nail involvement or genital psoriasis. Conclusion: In the real-life setting, adalimumab was the most effective biological agent for the treatment of plaque psoriasis.

Original languageEnglish
Pages (from-to)481-486
Number of pages6
JournalJournal of Dermatological Treatment
Issue number5
Publication statusPublished - 2018


  • adalimumab
  • biological drugs
  • etanercept
  • Psoriasis
  • psoriatic arthritis
  • ustekinumab

ASJC Scopus subject areas

  • Dermatology


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