Treatment with biologics has proved to be effective in moderate to severe psoriasis. Both the anti-CD11a monoclonal antibody efalizumab and the soluble TNFRII-IgG fusion protein etanercept have been shown to induce the clearing of psoriasis plaques in a high proportion of patients. However, clinical response to these drugs is often slow and cannot be predicted. The only marker of response is the clinical improvement of skin lesions after 12 weeks of treatment, which is often calculated by the PASI score. HLA-Cw6 is considered to be a psoriasis susceptibility gene and is part of the haplotype characterizing early-onset (type I) psoriasis. We have performed HLA-Cw6 haplotyping in 82 patients affected by moderate to severe plaque psoriasis treated with either efalizumab (34 patients) or etanercept (48 patients) and found that the response to efalizumab, but not to etanercept, is strictly linked to the presence of the HLA-Cw6 allele. Cw6- positive patients have a high response rate to efalizumab while response to this drug is very low in Cw6-negative patients. In the group of patients who took efalizumab, at week 12 PASI 50 was reached by 82% (18 of 22) of Cw6+ patients and by 58% (7 of 12) of Cw6– patients. The PASI 75 was achieved in 35% (8 of 22) of Cw6+ patients, and only in 2 of 12 Cw6– patients. In the group of patients treated with etanercept at week 12, PASI 50 was reached by 83% (25 of 30) of Cw6+ patients and by 94% (17 of 18) of Cw6– patients. The PASI 75 was reached by 16 of 30 (54%) of Cw6+ patients and by 15 of 18 (83%) of Cw6– patients. After 24 weeks, 72% (16 of 22) of Cw6+ patients treated with efalizumab show PASI 50, while 42% (5 of 12) of Cw6– patients have reached PASI 50. The PASI 75 was achieved by 64% (14 of 22) of Cw6+ patients and 25% of Cw6– patients. In the group of Cw6+ patients treated with etanercept, PASI 50 and PASI 75 were reached in 80% (23 of 30) and 77%, respectively. Although preliminary and based on a small number of patients, our data indicate Cw6 as a potential predictive marker for response to efalizumab treatment.

Costanzo, A., Talamonti, M., Botti, E., Spallone, G., Papoutsaki, M., Chimenti, S. (2009). HLA-Cw6 allele confers sensitivity to efalizumab treatment in psoriasis. In ABSTRACTS Psoriasis: From Gene to Clinic, 5th International Congress Accepted Papers [10.1111/j.1365-2133.2008.08912.x].

HLA-Cw6 allele confers sensitivity to efalizumab treatment in psoriasis

A costanzo;M talamonti;E Botti;G. Spallone;S Chimenti
2009-01-01

Abstract

Treatment with biologics has proved to be effective in moderate to severe psoriasis. Both the anti-CD11a monoclonal antibody efalizumab and the soluble TNFRII-IgG fusion protein etanercept have been shown to induce the clearing of psoriasis plaques in a high proportion of patients. However, clinical response to these drugs is often slow and cannot be predicted. The only marker of response is the clinical improvement of skin lesions after 12 weeks of treatment, which is often calculated by the PASI score. HLA-Cw6 is considered to be a psoriasis susceptibility gene and is part of the haplotype characterizing early-onset (type I) psoriasis. We have performed HLA-Cw6 haplotyping in 82 patients affected by moderate to severe plaque psoriasis treated with either efalizumab (34 patients) or etanercept (48 patients) and found that the response to efalizumab, but not to etanercept, is strictly linked to the presence of the HLA-Cw6 allele. Cw6- positive patients have a high response rate to efalizumab while response to this drug is very low in Cw6-negative patients. In the group of patients who took efalizumab, at week 12 PASI 50 was reached by 82% (18 of 22) of Cw6+ patients and by 58% (7 of 12) of Cw6– patients. The PASI 75 was achieved in 35% (8 of 22) of Cw6+ patients, and only in 2 of 12 Cw6– patients. In the group of patients treated with etanercept at week 12, PASI 50 was reached by 83% (25 of 30) of Cw6+ patients and by 94% (17 of 18) of Cw6– patients. The PASI 75 was reached by 16 of 30 (54%) of Cw6+ patients and by 15 of 18 (83%) of Cw6– patients. After 24 weeks, 72% (16 of 22) of Cw6+ patients treated with efalizumab show PASI 50, while 42% (5 of 12) of Cw6– patients have reached PASI 50. The PASI 75 was achieved by 64% (14 of 22) of Cw6+ patients and 25% of Cw6– patients. In the group of Cw6+ patients treated with etanercept, PASI 50 and PASI 75 were reached in 80% (23 of 30) and 77%, respectively. Although preliminary and based on a small number of patients, our data indicate Cw6 as a potential predictive marker for response to efalizumab treatment.
Psoriasis: From Gene to Clinic, 5th International Congress
London
Rilevanza internazionale
contributo
dic-2008
2009
Settore MED/35 - MALATTIE CUTANEE E VENEREE
English
HLA-Cw6; psoriasis, Efalizumab, Pharmacogenetics
Intervento a convegno
Costanzo, A., Talamonti, M., Botti, E., Spallone, G., Papoutsaki, M., Chimenti, S. (2009). HLA-Cw6 allele confers sensitivity to efalizumab treatment in psoriasis. In ABSTRACTS Psoriasis: From Gene to Clinic, 5th International Congress Accepted Papers [10.1111/j.1365-2133.2008.08912.x].
Costanzo, A; Talamonti, M; Botti, E; Spallone, G; Papoutsaki, M; Chimenti, S
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2108/198153
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