A pooled analysis of the phase 3 CIMPASI-1 and CIMPASI-2 studies with focus on psoriasis of head and neck showed that certolizumab pegol, an anti-TNFα monoclonal antibody, in a dose of 400 mg every second week leads to greatest improvement of this difficult-to-treat area .
The new assessment included data from 461 adult patients with moderate-to-severe psoriasis from the CIMPASI-1 and CIMPASI-2 trials. The analysis focussed on the head and neck was chosen, as visible psoriasis in these areas has a disproportionately high impact on patients’ quality of life .
Inclusion criteria also included a Psoriasis Area and Severity Index score (PASI) of ≥ 12, body surface area (BSA) ≥ 10%, and Physician’s Global Assessment (PGA) of ≥ 3 at baseline. Randomisation allocated 186 patients to the group treated with 200 mg certolizumab pegol every second week, 175 patients receiving 400 mg certolizumab every second week, and 100 patients to placebo. The initial treatment within the RCTs lasted over 16 weeks. All study participants reaching at least a 50% improvement of PASI (primary study endpoint) continued maintenance at the previous dosage through week 48. Co-primary endpoints were: PASI75 defined as responder rate along with PGA of 0/1 and improvement of ≥ 2 points.
The post-hoc analysis analysed achievement of 75% and 90% improvement of psoriatic lesions on head and neck and the mean difference from baseline in these locations. Mean score values for PASI on head and neck before treatment were 2.1 in the lower certolizumab dose group, 2.4 in the higher dose group, and 2.4 in the placebo group.
At week 16, 80% of the patients taking the higher dose of certolizumab and 70.4 % of those in the 200 mg certolizumab group reached PASI 75 on head and neck, compared with 14.9% of the patients on placebo (see Figure). Rates for PASI 90 were 70.3%, 56.8%, and 9.3%, respectively. Response was lasting through week 48 with changes from baseline of -88.3% with the 400 mg dose and -76.5% with the 200 mg dose. All in all, these results indicate that certolizumab is an effective treatment for head and neck psoriasis.
Figure: Improvements in PASI of the head and neck region through weeks 0-48 
PASI, Psoriasis Area and Severity Index; CZP, certolizumab.
- Van de Kerkhof P et al. P1617, EADV 2019, 9-13 Oct, Madrid, Spain.
- Merola JF, et al. Dermatol Ther. 2018;31:e12589.
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Table of Contents: EADV 2019
Letter from the Editor
IL-17A blocker effective in paediatric psoriasis patients
Rituximab beats mycophenolate mofetil in pemphigus vulgaris
Novel JAK1/2 inhibitor shows remarkable efficacy in alopecia areata
Acne highly influenced by climate, pollutants, and unhealthy diet
JAK inhibition plus TCS lead to high clearance rates in AD
No cancer risk with long-term use of tacrolimus, a topical calcineurin inhibitor, in children with AD
Green light for a second JAK inhibitor in AD
Topical ruxolitinib effective in vitiligo
Small molecules: interesting novel treatment options in AD
IL-1⍺ blockade: a new treatment option in AD
IL-4/IL-13 blockade leads to rapid itch reduction in adolescents
How to manage conjunctivitis in AD patients treated with a biologic
Biologics: increasingly used in paediatric dermatology
Spotlight on Psoriasis
IL-17 blocker: effective and safe in patients with comorbidities
ESPRIT registry: sharp decline in mortality in patients treated with a TNF blocker
Relationship psoriasis and NAFLD: new data on the hepato-dermal axis
Novel selective IL-23 blocker equally effective in patients with metabolic syndrome
Selective IL-23 blocker crushes fumaric acids in all assessed efficacy endpoints
No hint of teratogenicity through ixekizumab
New Insights in Photoprotection
Systemic photoprotection: a valuable addition to topical sun protection
The underestimated effect of visible light
Comorbidities more common in chronic urticaria, psoriasis, and AD
D-Dimer as future biomarker in CSU management?
Ligelizumab for CSU: symptom control and high response rates in re-treatment
Rosacea – From New Spectrum to New Therapy
New guidance on rosacea therapy according to phenotype
Best of the Posters
Above-the-neck melanoma more prone to metastases
Reduced sleep quality in dermatoses influenced by itch and pain
Anxiety and depression are common in families of AD infants
Certolizumab pegol efficacious for head and neck psoriasis
Age at disease onset: a key factor in understanding psoriasis