Clinical response in psoriasis patients discontinued from and then reinitiated on etanercept therapy

Background: Although continuous therapy with the tumor necrosis factor (TNF) antagonist, etanercept, has been shown to have a favorable benefit to risk profile in the treatment of moderate to severe plaque psoriasis, it is recognized that patients and practioners may wish for intermittent treatment should life circumstances dictate. Objective: To evaluate safety and effect maintenance of etanercept retreatment in psoriasis. Methods: Results of a 24-week, randomized, placebo-controlled, double-blind study were previously reported. Patients who responded at week 24 (improved ≥50% in psoriasis area and severity index [PASI]) discontinued etanercept until disease relapse (loss of ≥50% of week 24 PASI improvement). Patients were retreated with blinded etanercept at the originally randomized dose: 25 mg or 50 mg twice weekly (BIW) or 25 mg once weekly; original placebo patients received 25 mg BIW for the final 12 weeks of the double-blind period and were retreated with etanercept 25 mg BIW. Results: Psoriasis returned gradually, without untoward events, within, on average, 3 months after etanercept discontinuation. Results after 12 weeks of retreatment were similar to those achieved after the initial 12 weeks. The major limitation of this study is that it examines only one round of discontinuation/retreatment. Conclusions: Retreatment with etanercept was effective and well tolerated in psoriasis patients.