Patients with psoriasis respond to continuous open-label etanercept treatment after initial incomplete response in a randomized, placebo-controlled trial

Background: Etanercept provides rapid, significant improvement in psoriatic symptoms and disease. Objective. The effectiveness of continued etanercept treatment beyond 24 weeks in patients who initially did not achieve at least a 50% improvement from baseline in the Psoriasis Area and Severity Index (PASI 50) was assessed. Methods: Patients with moderate to severe plaque psoriasis received 50 mg open-label, subcutaneous etanercept per week after completing blinded therapy with placebo or 1 of 3 doses of etanercept. The PASI was measured. Results: Irrespective of prior closing regimens, 43% of 157 patients who did not attain PASI 50 responses at week 24 achieved PASI 50 responses at week 36; 55% achieved PASI 50 responses at week 60. Etanercept was safe and well tolerated. Limitations: Interpretation of these results is limited by the open-label design of the analysis. Conclusion. More than half of patients who initially had an inadequate response to treatment achieved satisfactory responses with continued etanercept therapy. The safety profile of etanercept in these patients and in patients who had more immediate responses was similar.