Efficacy, tolerability and safety of switching from etanercept to infliximab for the treatment of moderate-to-severe psoriasis: A multicenter, open-label trial (TANGO)

Abstract

Biologic anti-tumor necrosis factor-α (anti-TNF-α) therapies have revolutionized the management of psoriasis. However, despite similar mechanisms of action, inter-patient variability in the clinical responses to therapy remain unexplained. Possible differences between agents include stability or bioavailability and anti-drug antibody development, and patient factors such as compliance may play a role. As a result, it is not uncommon for physicians to switch a patient from one anti-TNF-α agent to another when initial response is inadequate. This multicenter, single-arm, observational, Phase IV study assessed the efficacy and safety of infliximab therapy in patients with moderate-to-severe psoriasis who had not responded to 24 weeks' etanercept treatment. Drug efficacy was assessed using specific psoriasis indexes; health-related quality of life (HRQoL) was measured using the Dermatology Life Quality Index and the Skindex-29. A total of 48 patients were screened, 38 were treated with infliximab and 31 completed the study. Of these, 71% achieved Psoriasis Area and Severity Index 75 after 10 weeks, and improvement in HRQoL was documented. The results of this study showed that patients with moderate-to-severe psoriasis could be successfully switched from etanercept to infliximab, with improvements in both clinical parameter and HRQoL.

• Etanercept
• infliximab
• psoriasis
• quality of life
• switching

Acknowledgements

The authors thank all the co-investigators from the TANGO study group who participated in the clinical trial (Pier Luigi Amerio, Nikkels Arjen, Anna Balato, Maria Grazia Bernengo, Boyden Bert, Giovanni Borroni, Stefano Calvieri, Ruggero Caputo, Michel De La Brassine, Jozef De Weert, Biagio Didona, Giovanni Flati, Pierre-Dominique Ghislain, Giampiero Girolomoni, Serena Lembo, Torello Lotti, Patrizia Martini, Andrea Peserico, Antonio Puglisi-Guerra, Diane Rosseeuw, Patrizio Sedona, Giovanni Valenti, and Gino Antonio Vena).

Declaration of interest

F.A. has served as a speaker, consultant or advisory board member for Abbott, Janssen-Cilag, MSD, Novartis, and Pfizer. In the past 3 years, he has been paid as a consultant (or in a similar capacity) by, and has received research or educational support from, a company with a vested interest in the product being studied. In addition, in relation to the present article, it is to be declared that some of the data that were used in this study were provided by a company with a vested interest in the product being studied, and the sponsor of this project had the right to comment but final decisions were made by the authors.

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.