ESPRIT registry: sharp decline in mortality in patients treated with a TNF blocker

An analysis of registry data showed that patients with moderate-to-severe psoriasis treated with adalimumab had a 58% lower standardised mortality rate compared with the general population [1].

ESPRIT is an ongoing international, prospective, observational registry evaluating the long-term safety and effectiveness of the TNF blocker adalimumab in adults with moderate-to-severe chronic plaque psoriasis under real-world conditions. Ten-year data was analysed from 6,014 psoriasis patients with collectively 28,161 person-years on adalimumab in routine clinical practice.

“You may not believe it if someone tells you that you, as a dermatologist, can save patient lives by controlling psoriasis,” said Prof. Diamant Thaçi (University of Lübeck, Germany). Yet, this was exactly what the data showed: the standardised mortality ratio in participants in the ESPRIT registry was 58% lower than expected. A total of 144 deaths were predicted in the matched general population, yet only 60 deaths occurred in adalimumab-treated registry participants.

In addition, the incidence rates of serious infections, malignancies, and cardiovascular events in ESPRIT participants remained stable over time and well within the range of published rates in psoriasis patients not on biologic therapy. No new safety signals were observed and safety was consistent with the known safety profile of adalimumab.

As Prof. Thaçi pointed out, the positive mortality result is unexpected because the ESPRIT participants were typical for patients with moderate-to-severe psoriasis one usually encounters in clinical practice: many of them have cardiovascular risk factors, e.g. obesity and a substantial burden of comorbid conditions. The efficacy of adalimumab remained stable over the 10-year- period. “This result demonstrates the importance of good control of psoriasis,” concluded Prof. Thaçi.

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   1. Thaçi D. FC01.02, EADV 2019, 9-13 Oct, Madrid, Spain.

Posted on 9 October 201916 February 2024