MARC 主機 00000nam  2200373   4500 
001    AAI3171120 
005    20070822131036.5 
008    070822s2005                        eng d 
020    9780542078927 
035    (UMI)AAI3171120 
040    UMI|cUMI 
100 1  Al-Abdouli, Khuloud Asad 
245 13 An open-label, randomized, prospective study to evaluate 
       the effectiveness and safety of continuous long-term 
       versus intermittent etanercept in the treatment of 
300    129 p 
500    Source: Dissertation Abstracts International, Volume: 66-
       04, Section: B, page: 1966 
500    Major Professor:  Tania Phillips 
502    Thesis (Sc.D.)--Boston University, 2005 
520    Background. Psoriasis is recognized as the most prevalent 
       T cell-mediated immune disease in which CD4+ and CD8 + 
       memory effector T cells stimulate the hyperproliferation 
       of keratinocytes. TNF is a pro-inflammatory cytokine known
       to play an important role in the pathogenesis of 
       psoriasis. Etanercept acts as a competitive inhibitor of 
       tumor necrosis factor (TNF) and blocks its interaction 
       with cell surface TNF receptors 
520    Aim. To evaluate the effectiveness and safety of 
       continuous long-term versus intermittent etanercept in the
       treatment of psoriasis 
520    Method. All patients (n = 9) received etanercept 50 mg 
       twice weekly SC for the first 12 weeks. At week 12 
       patients were randomized equally (1:1) to one of two 
       treatment groups, the continuous therapy and intermittent 
       therapy. The continuous therapy group received etanercept 
       50 mg once weekly SC for weeks 13 through 24. The 
       intermittent therapy group was assessed for response. 
       Those who achieved a responder status (PGA score ≤ 2 
       and improved from baseline) at week 12 discontinued 
       therapy. Upon relapse of PGA responder status at week 16 
       or 20, etanercept will resumed at a dose of 50 mg once 
       weekly SC through week 24. Patients who had not achieved a
       responder status on PGA at week 12 continued etanercept 
       without interruption, as in the continuous therapy group 
520    Results. In the first 12 weeks, all patients (n = 9) 
       improved in all three parameters, BSA% (P = 0.048), PGA (p
       = 0.013), and Scalp score (p = 0.0083). These results 
       demonstrated statistically significant improvement 
       compared to baseline. In the second half of the study, 
       (from week 12 to 24) there was statistically significant 
       difference in BSA% in the continuous therapy group 
       compared to the intermittent therapy group (p = 0.012). 
       However there was no difference in PGA (p = 0.12) and 
       Scalp score (p = 0.34) 
520    Conclusion. Our study shows that continuous therapy 
       appears to be more effective than intermittent therapy 
       with improvement in BSA%. Relapse (defined as PGA > 2) 
       only occurred in the intermittent group. Two patients 
       relapsed at week 16 (40%), one relapsed at week 20 (20%), 
       and two did not relapse by 24 weeks. Etanercept was safe 
       and well tolerated in both groups. No serious events 
       occurred during the study. Three patients (3/9) had the 
       most common drug related adverse events, injection site 
       reactions (33%). Four patients (4/9) did not have drug 
       related adverse events. Other adverse events were 
       considered unrelated to the study drug 
590    School code: 0017 
590    DDC 
650  4 Health Sciences, Pharmacology 
650  4 Health Sciences, Immunology 
690    0419 
690    0982 
710 20 Boston University 
773 0  |tDissertation Abstracts International|g66-04B 
856 40 |u