Adalimumab is a fully human anti-TNF-a monoclonal antibody currently in phase 2 studies for the treatment of moderate to severe psoriasis. It is currently approved for the treatment of rheumatoid arthritis as a second-line agent, alone or in combination with a disease-modifying anti-rheumatic drug (DMARD) and psori-atic arthritis. Adalimumab is given as a 40 mg subcutaneous injection every 2 weeks. A phase 2 trial by Chen and colleagues found that 53 % of study patients receiving 40 mg every other week achieved a PASI-75, and 80 % of patients receiving 40 mg weekly achieved a PASI-75. The percentages of patients achieving a PASI-75 were statistically significantly greater than placebo as early as 4 weeks. As discussed with etanercept and infliximab, adalimumab has the same important side effects as the other TNF- inhibitors exhibit.
Adalimumab is currently undergoing a phase 3 investigational study for the treatment of moderate to severe psoriasis. In addition to psoriasis, there have been case reports on the successful use of adalimumab in the treatment of recalcitrant acrodermatitis continua of Hallopeau (with acitretin), psoriatic onycho-pachydermo periostitis (POPP), pyoderma gangreno-sum, and refractory rheumatoid arthritis-associated leg ulcerations.
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