The response to anti-TNF ab therapy is variable in patients with psoriasis.
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1
Municipal Tsuruga Hospital, Japan
Psoriasis is a proliferative epidermal disorder with immunological background. While some monoclonal antibody therapies against immune mediators are available for the patients, efficacy of the therapy is highly variable. We describe the diversity of anti-TNF ab effects against the psoriasis patients. We treated 7 psoriasis patients by anti-TNF ab. The therapy was effective for 5 patients, while it was not effective for 1 patient. One patient developed pneumocystis carinii pneumonia after the therapy. The TNF resistant was successfully treated by IL23 blocker. However, there was no sign or specific clinical features in this patient, when compared to other patients who were improved by TNF therapy. Although it was unclear in this study, the identification of genetic and/or disease variants has the potential to improve the selection of the drug. A suitable approach in implementing such a strategy could potentially reduce medical costs and improve success of drug therapy. Since ~20% of patients do not respond to TNF therapy, we may focus on these patients and TNF related molecules. Further, the evaluation might include experimental/preclinical studies, using patient own skin/immune cells and candidate drugs. Thus, personalized medicine will mandate special physicians capable of understanding molecular medicine in addition to genetics and biomarkers for diagnosis, evaluation of the effect of drugs, and overall prognosis.
Keywords:
Psoriasis,
Tumor Necrosis Factor-alpha,
personalized medicine,
IL-23,
Cost Control
Conference:
15th International Congress of Immunology (ICI), Milan, Italy, 22 Aug - 27 Aug, 2013.
Presentation Type:
Abstract
Topic:
Translational immunology and immune intervention
Citation:
Komura
K
(2013). The response to anti-TNF ab therapy is variable in patients with psoriasis..
Front. Immunol.
Conference Abstract:
15th International Congress of Immunology (ICI).
doi: 10.3389/conf.fimmu.2013.02.00137
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Received:
11 Mar 2013;
Published Online:
22 Aug 2013.
*
Correspondence:
Dr. Kazuhiro Komura, Municipal Tsuruga Hospital, Tsuruga, Japan, komuraka@me.com