Sensitive biomarkers help determine early changes in those with psoriatic arthritis (PsA). Marjan de Groot, MD, and colleagues published a study in Dermatology in 2012 that determined which changes in the skin best correlate with clinical improvement during the study. The changes were observed in both lesional and nonlesional skin in 18 total patients (24 patients enrolled, but 6 did not meet requirements based on the activity of their lesions and the availability of samples).
The study was a randomized, double-blind, placebo-controlled, single-center study, and the clinical changes as well as the immunohistological changes in the skin were analyzed at baseline and after 4 weeks. Patients were divided into treatment and placebo groups in a 1:1 ratio, and either 40 mg of adalimumab or placebo were injected into the respective patients at baseline and at 2 weeks. Samples of 4 mm skin biopsies were also taken from each patient inlesional and nonlesional areas at baseline and at week 4 for comparison. After a period of incubation, the samples were stained and analyzed for the presence of certain immuno-histological markers. The patients were clinically evaluated using the Psoriasis Area and Severity Index (PASI) and a Body Surface Area (BSA) assessment.
There was an apparent clinical improvement in patients treated with adalimumab compared with the placebo group. However, the PASI reduction slightly missed signifcance, possibly because the PsA patients had been chosen for their arthritis and not for the severity of their psoriasis, meaning that many of their PASI scores were relatively low to start, according to researchers. In the adalimumab group, the mean PASI score decreased from 5.89 to 4.01, and the mean BSA decreased from 4.88 to 3.79. All clinical improvements were sustained at week 12.
Adalimumab treatment did not signifcantly decrease any immunohistological markers in lesional or nonlesional skin until an analysis of covariance was applied to correct for the imbalance at baseline. When that was put in place, adalimumab treatment in lesional skin showed a signifcant decrease in dermal CD161+ and elastace cells. There was also a correlation between the improvement in PASI and reduction of elastace cells. In another study, similar results were observed after treatment with etanercept. It can be concluded that CD161+ and elastace may be helpful biomarkers to deter- mine the effcacy of treatment in early stages, though further research is needed.
Sensitive biomarkers help determine early changes in those with psoriatic arthritis (PsA). Marjan de Groot, MD, and colleagues published a study in Dermatology in 2012 that determined which changes in the skin best correlate with clinical improvement during the study. The changes were observed in both lesional and nonlesional skin in 18 total patients (24 patients enrolled, but 6 did not meet requirements based on the activity of their lesions and the availability of samples).
The study was a randomized, double-blind, placebo-controlled, single-center study, and the clinical changes as well as the immunohistological changes in the skin were analyzed at baseline and after 4 weeks. Patients were divided into treatment and placebo groups in a 1:1 ratio, and either 40 mg of adalimumab or placebo were injected into the respective patients at baseline and at 2 weeks. Samples of 4 mm skin biopsies were also taken from each patient inlesional and nonlesional areas at baseline and at week 4 for comparison. After a period of incubation, the samples were stained and analyzed for the presence of certain immuno-histological markers. The patients were clinically evaluated using the Psoriasis Area and Severity Index (PASI) and a Body Surface Area (BSA) assessment.
There was an apparent clinical improvement in patients treated with adalimumab compared with the placebo group. However, the PASI reduction slightly missed signifcance, possibly because the PsA patients had been chosen for their arthritis and not for the severity of their psoriasis, meaning that many of their PASI scores were relatively low to start, according to researchers. In the adalimumab group, the mean PASI score decreased from 5.89 to 4.01, and the mean BSA decreased from 4.88 to 3.79. All clinical improvements were sustained at week 12.
Adalimumab treatment did not signifcantly decrease any immunohistological markers in lesional or nonlesional skin until an analysis of covariance was applied to correct for the imbalance at baseline. When that was put in place, adalimumab treatment in lesional skin showed a signifcant decrease in dermal CD161+ and elastace cells. There was also a correlation between the improvement in PASI and reduction of elastace cells. In another study, similar results were observed after treatment with etanercept. It can be concluded that CD161+ and elastace may be helpful biomarkers to deter- mine the effcacy of treatment in early stages, though further research is needed.
Sensitive biomarkers help determine early changes in those with psoriatic arthritis (PsA). Marjan de Groot, MD, and colleagues published a study in Dermatology in 2012 that determined which changes in the skin best correlate with clinical improvement during the study. The changes were observed in both lesional and nonlesional skin in 18 total patients (24 patients enrolled, but 6 did not meet requirements based on the activity of their lesions and the availability of samples).
The study was a randomized, double-blind, placebo-controlled, single-center study, and the clinical changes as well as the immunohistological changes in the skin were analyzed at baseline and after 4 weeks. Patients were divided into treatment and placebo groups in a 1:1 ratio, and either 40 mg of adalimumab or placebo were injected into the respective patients at baseline and at 2 weeks. Samples of 4 mm skin biopsies were also taken from each patient inlesional and nonlesional areas at baseline and at week 4 for comparison. After a period of incubation, the samples were stained and analyzed for the presence of certain immuno-histological markers. The patients were clinically evaluated using the Psoriasis Area and Severity Index (PASI) and a Body Surface Area (BSA) assessment.
There was an apparent clinical improvement in patients treated with adalimumab compared with the placebo group. However, the PASI reduction slightly missed signifcance, possibly because the PsA patients had been chosen for their arthritis and not for the severity of their psoriasis, meaning that many of their PASI scores were relatively low to start, according to researchers. In the adalimumab group, the mean PASI score decreased from 5.89 to 4.01, and the mean BSA decreased from 4.88 to 3.79. All clinical improvements were sustained at week 12.
Adalimumab treatment did not signifcantly decrease any immunohistological markers in lesional or nonlesional skin until an analysis of covariance was applied to correct for the imbalance at baseline. When that was put in place, adalimumab treatment in lesional skin showed a signifcant decrease in dermal CD161+ and elastace cells. There was also a correlation between the improvement in PASI and reduction of elastace cells. In another study, similar results were observed after treatment with etanercept. It can be concluded that CD161+ and elastace may be helpful biomarkers to deter- mine the effcacy of treatment in early stages, though further research is needed.
