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) . 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.
- Kurd SK, et al, Arch Dermatol. 2010;146:891-5.
- Tribó MJ, et al. Acta Derm Venereol. 2019;99:417-22.
- 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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Table of Contents: SPIN 2022
Letter from the Editor
SPIN 2022 Highlights Podcast
IMIDs in Adults and Children: New Developments
Therapies for atopic dermatitis: still moving forward
Children with AD: high risk of bacterial infections in carriers of a filaggrin gene variant
Men on biologics report fewer adverse events than women
Conceptual framework of adverse drug reactions may improve treatment of patients with IMIDs
Psoriasis: The Beat Goes On
Systemic treatment for psoriasis: what is on the horizon?
Topical therapy in psoriasis: an important partner in combination therapy
GPP flares: pronounced undertreatment is common
IL-17A/F inhibitor bimekizumab shows higher response and maintenance rates compared with secukinumab
Paediatric psoriasis: ixekizumab beneficial in difficult-to-treat areas
Psoriasis patients see great benefit in achieving complete skin clearance
The Future Is Bright for Vitiligo
Predilection sites for skin signs of vitiligo disease activity determined
Where Are We Now in Hidradenitis Suppurativa
IHS4 better suited as an outcome measure in HS trials?
New treatments for HS: IL-17 inhibitors next in practice?
New Treatment Options in Alopecia Areata
Alopecia areata: light at the end of the tunnel
Alopecia areata pathogenesis: known genetic background, unknown environmental triggers
Best of the Posters
Psoriasis treatment: no elevation of MACE and VTE on deucravacitinib
Comorbid anxiety and depression may benefit from psoriasis treatment with certolizumab
Dose tapering in psoriasis is associated with a low relapse rate
IL-17A blocker effective in paediatric psoriasis patients