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Efficacy and safety of TNF blockers and of ustekinumab in palmoplantar pustulosis and in acrodermatitis continua of Hallopeau.
J Eur Acad Dermatol Venereol. 2020 Oct; 34(10):2330-2338.JE

Abstract

BACKGROUND

Palmoplantar pustulosis (PPP) and acrodermatitis continua of Hallopeau (ACH) are rare variants of psoriasis. Knowledge of the efficacy of biologics is scarce.

OBJECTIVES

To evaluate the real-life efficacy of tumour necrosis factor blockers and ustekinumab in PPP and in ACH.

METHODS

A multicentre retrospective descriptive study was conducted in 19 dermatology departments, including all patients with PPP or ACH seen from 2014 to 2016 who received one of the studied biologics. The data were collected by a standardized document. Factors associated with complete clearance (CC) were analysed by multivariate analysis, estimating odds ratios (ORs) and 95% confidence intervals (CIs).

RESULTS

Among 92 patients included, 50 received adalimumab, 44 ustekinumab, 36 etanercept and 31 infliximab. Improvement and CC were observed in 83.9% and 20.0% patients receiving infliximab, 75.0% and 38.6% ustekinumab, 57.1% and 20.0% etanercept and 60.4% and 29.2% adalimumab. We found no significant difference in CC rates or duration of treatment among the biological treatments (P = 0.18 and P = 0.10, respectively). On multivariate analysis, CC with etanercept was associated with the ACH form and not smoking [OR = 9.5 (95% CI 1.1-82.7), P = 0.04 and 0.1 (0.01-0.9), P = 0.04]; with ustekinumab, male sex and absence of obesity [6.0 (1.3-28.6), P = 0.02 and 4.7 (1.0-22.7), P = 0.05]; with adalimumab, the ACH form [11.9 (2.7-52.3), P = 0.001]; and with infliximab, obesity [5.6 (1.1-29.4), P = 0.04].

CONCLUSIONS

We found no difference in efficacy between TNF blockers and ustekinumab and among the three different TNF blockers in real life for PPP or ACH, which reveals the heterogeneity of clinical response to biologics in pustular psoriasis as compared with plaque psoriasis.

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Husson B
Dermatology Department, Hôpital Robert-Debré, Reims, France.
Barbe C
Clinical Research Unit, Hôpital Robert-Debré, Reims, France.
Hegazy S
Dermatology Department, Hôpital Larrey, Toulouse, France.
Seneschal J
Dermatology Department, National Reference Center for Rare Skin Diseases, Hôpital Saint-André, Bordeaux, France.
Aubin F
Dermatology Department, Centre Hospitalo-Universitaire (CHU), Besançon, France.
Mahé E
Dermatology Department, Centre Hospitalier (CH), Argenteuil, France.
Jullien D
Clinical Immunology Department, CH Lyon-Sud, Lyon, France.
Sbidian E
Dermatology Department, Hôpital Henri-Mondor, Créteil, France.
D'Incan M
Dermatology Department, CHU Estaing, Clermont-Ferrand, France.
Conrad C
Dermatology Department, Lausanne University Hospital, CHUV, Lausanne, Switzerland.
Brenaut E
Dermatology Department, CHU, Brest, France.
Girard C
Dermatology Department, CHU Lapeyronie, Montpellier, France.
Richard MA
Dermatology Department, CEReSS-EA 3279, Research Center in Health Services and Quality of Life Aix Marseille University, Universitary Hospital Timone, Assistance Publique Hôpitaux de Marseille, Marseille, France.
Bachelez H
Université de Paris, Paris, France. Dermatology Department, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Paris, France. Laboratory of Genetics of Skin Diseases, INSERM UMR1163, Institut Imagine, Necker Hospital, Paris, France.
Viguier M
Dermatology Department, Hôpital Robert-Debré, Reims, France.
« Groupe de Recherche sur le Psoriasis » de la Société Française de Dermatologie
No affiliation info available

MeSH

AcrodermatitisAdalimumabEtanerceptHumansInfliximabMalePsoriasisRetrospective StudiesTumor Necrosis Factor InhibitorsUstekinumab

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

32030802

Citation

Husson, B, et al. "Efficacy and Safety of TNF Blockers and of Ustekinumab in Palmoplantar Pustulosis and in Acrodermatitis Continua of Hallopeau." Journal of the European Academy of Dermatology and Venereology : JEADV, vol. 34, no. 10, 2020, pp. 2330-2338.
Husson B, Barbe C, Hegazy S, et al. Efficacy and safety of TNF blockers and of ustekinumab in palmoplantar pustulosis and in acrodermatitis continua of Hallopeau. J Eur Acad Dermatol Venereol. 2020;34(10):2330-2338.
Husson, B., Barbe, C., Hegazy, S., Seneschal, J., Aubin, F., Mahé, E., Jullien, D., Sbidian, E., D'Incan, M., Conrad, C., Brenaut, E., Girard, C., Richard, M. A., Bachelez, H., & Viguier, M. (2020). Efficacy and safety of TNF blockers and of ustekinumab in palmoplantar pustulosis and in acrodermatitis continua of Hallopeau. Journal of the European Academy of Dermatology and Venereology : JEADV, 34(10), 2330-2338. https://doi.org/10.1111/jdv.16265
Husson B, et al. Efficacy and Safety of TNF Blockers and of Ustekinumab in Palmoplantar Pustulosis and in Acrodermatitis Continua of Hallopeau. J Eur Acad Dermatol Venereol. 2020;34(10):2330-2338. PubMed PMID: 32030802.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Efficacy and safety of TNF blockers and of ustekinumab in palmoplantar pustulosis and in acrodermatitis continua of Hallopeau. AU - Husson,B, AU - Barbe,C, AU - Hegazy,S, AU - Seneschal,J, AU - Aubin,F, AU - Mahé,E, AU - Jullien,D, AU - Sbidian,E, AU - D'Incan,M, AU - Conrad,C, AU - Brenaut,E, AU - Girard,C, AU - Richard,M A, AU - Bachelez,H, AU - Viguier,M, AU - ,, Y1 - 2020/03/30/ PY - 2019/10/28/received PY - 2020/01/21/accepted PY - 2020/2/8/pubmed PY - 2021/5/15/medline PY - 2020/2/8/entrez SP - 2330 EP - 2338 JF - Journal of the European Academy of Dermatology and Venereology : JEADV JO - J Eur Acad Dermatol Venereol VL - 34 IS - 10 N2 - BACKGROUND: Palmoplantar pustulosis (PPP) and acrodermatitis continua of Hallopeau (ACH) are rare variants of psoriasis. Knowledge of the efficacy of biologics is scarce. OBJECTIVES: To evaluate the real-life efficacy of tumour necrosis factor blockers and ustekinumab in PPP and in ACH. METHODS: A multicentre retrospective descriptive study was conducted in 19 dermatology departments, including all patients with PPP or ACH seen from 2014 to 2016 who received one of the studied biologics. The data were collected by a standardized document. Factors associated with complete clearance (CC) were analysed by multivariate analysis, estimating odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS: Among 92 patients included, 50 received adalimumab, 44 ustekinumab, 36 etanercept and 31 infliximab. Improvement and CC were observed in 83.9% and 20.0% patients receiving infliximab, 75.0% and 38.6% ustekinumab, 57.1% and 20.0% etanercept and 60.4% and 29.2% adalimumab. We found no significant difference in CC rates or duration of treatment among the biological treatments (P = 0.18 and P = 0.10, respectively). On multivariate analysis, CC with etanercept was associated with the ACH form and not smoking [OR = 9.5 (95% CI 1.1-82.7), P = 0.04 and 0.1 (0.01-0.9), P = 0.04]; with ustekinumab, male sex and absence of obesity [6.0 (1.3-28.6), P = 0.02 and 4.7 (1.0-22.7), P = 0.05]; with adalimumab, the ACH form [11.9 (2.7-52.3), P = 0.001]; and with infliximab, obesity [5.6 (1.1-29.4), P = 0.04]. CONCLUSIONS: We found no difference in efficacy between TNF blockers and ustekinumab and among the three different TNF blockers in real life for PPP or ACH, which reveals the heterogeneity of clinical response to biologics in pustular psoriasis as compared with plaque psoriasis. SN - 1468-3083 UR - https://www.unboundmedicine.com/medline/citation/32030802/Efficacy_and_safety_of_TNF_blockers_and_of_ustekinumab_in_palmoplantar_pustulosis_and_in_acrodermatitis_continua_of_Hallopeau_ DB - PRIME DP - Unbound Medicine ER -