Comorbid anxiety and depression may benefit from psoriasis treatment with certolizumab

Treatment of psoriasis with certolizumab could also have a positive impact on depression or anxiety. This is suggested by the results of a pooled analysis of the phase 3 CIMPASI-1 and -2 trials, in which almost half of the depressive and nearly one-third of the anxiety patients achieved a substantial reduction in their disease scores.

A diagnosis of depression and anxiety is more likely in patients with psoriasis than in the general population, and an association between the depression risk and the disease severity has also been identified [1,2]. But does the treatment of psoriasis with certolizumab pegol also affect comorbid anxiety or depression? Pooled data from 3-year phase 3 CIMPASI-1 and -2 trials (NCT02326298 and NCT02326272) was used to assess the resolving rate of these conditions through the Hospital Anxiety and Depression Scale (HADS) [3]. HADS allocates higher values to more severe symptoms, and scores of 11–21 stand for moderate-to-severe disease, while values ≤7 represent no anxiety/depression.

CIMPASI-1 and -2 included a double-blind treatment and maintenance phase from weeks 0–16 and 16–48, followed by an open-label extension through week 144 and a safety follow-up to week 152. The 361 participants with psoriasis receiving certolizumab pegol every second week, received a dosage of 200 mg or 400 mg. The mean baseline age was 45.3 years, and 36.8% were women. The mean baseline Dermatology Life Quality Index (DLQI) was 14.0, the mean HADS-Anxiety was 6.2 with 13.3% ≥11, and the mean HADS-Depression was 4.9 with 9.7% ≥11.

In general, about 31.3% of the participants with anxiety and 47.1% of those with depression achieved HADS scores ≤7. The analysis also revealed a mean reduction of the HADS-Anxiety score of 3.4 after 16 weeks of certolizumab pegol, which further lowered to -4.1 at week 144. The decrease in the HADS-Depression score was also carried on from -5.0 (week 16) to -5.1 (week 144). Of note, a difference of 1.7 is considered minimal clinically important.

The lead author Prof. April Armstrong (Keck School of Medicine of USC, CA, USA) and her colleagues pointed out that, although the number of enrolled participants with anxiety and depression was limited, certolizumab was associated with durable improvements in anxiety and depression for psoriasis patients over 3 years.

1. Kurd SK, et al, Arch Dermatol. 2010;146:891-5.
2. Tribó MJ, et al. Acta Derm Venereol. 2019;99:417-22.
3. Armstrong A, et al. Improvements in anxiety and depression among patients with moderate to severe plaque psoriasis treated with certolizumab pegol: Three-year results from two phase 3 trials (CIMPASI-1 and CIMPASI-2). P089, SPIN 2022 Congress, 06–08 July, Paris, France.

 

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Posted on 26 August, 20221 February, 2024