We present the results on retrospective analysis about the efficacy of Certolizumab Pegol (CZP), an anti-tumor necrosis factor-alpha agent, as monotherapy on skin psoriasis (PsO) in patients affect both by psoriatic arthritis (PsA) and mild-severe PsO. To date, the CZP is authorized for the treatment of PsA beyond that rheumatoid arthritis, axial spondyloarthritis/ankylosing spondylitis, and Crohn's disease but still not for PsO.Assessments included an evaluation of the Psoriasis Area and Severity Index (PASI). Twelve patients (9M and 3F mean age 57.8±8 years) were enrolled in our study. Nine patients had been previously treated with others biologic agents, three patients were naïve. Clinical and laboratory evaluations including Psoriasis area and Severity Index (PASI), erythrosedimentation rate (ESR) and C-reactive Protein (CRP) were performed at baseline (BL), at week 12 (W12), week 24 (W24) and week 52 (W52) of treatment. Although combination between Methotrexate and CZP is allowed, we included, in our study, patients treated only with CZP. In such a way as to be as specific as possible topical corticosteroids, vitamin D derivatives, retinoid creams, Anthralin derivatives as well as p-UVA or UV-B have been forbidden to enrolled patients. With the same purpose, all the patients used 2 times a day the identical moisturizing cream.Mean PASI score decreased from 18 (BL) to 0 (W52) as follows: 18 at BL, 4 at W12, 0 at W24 and 0 at W52. Severe adverse events were not reported. Safety evaluations were performed every 3 months: liver and renal functions were monitored in all patients during the treatment, and no patient presented abnormal values.To the best of our knowledge this is the first report that highlights the efficacy of CZP as monotherapy in psoriasis with mild to severe cutaneous involvement. Although to date the drug is authorized only for PsA our results demonstrate that CZP is safe and effective on both cutaneous and joint components representing, therefore, an effective option in the treatment of cutaneous symptoms of PsO. Limitations of our study are represented by the relatively short observation time (W52) and by numeric small study group. Long-term data with a larger number of enrolled patients are necessary in order to confirm our preliminary observations. This article is protected by copyright. All rights reserved.
