Abstract: Zhang Ruili, Zhu Xiaohong, Hua Haikang, Yang Lijia Department of Dermatology, Wuxi Second Hospital, Nanjing Medical University, Wuxi 214002, China Corresponding authors: Hua Haikang, Email: 1224634881@qq.com; Yang Lijia, Email: yanglijia726@163.com 【Abstract】 Objective To evaluate the clinical efficacy and safety of adalimumab for the treatment of severe psoriasis. Methods Between December 2015 and August 2017, 14 patients with severe psoriasis who showed no response to traditional therapy were enrolled into this study. All the patients received subcutaneous injection of adalimumab at an initial dose of 80 mg, which decreased to a dose of 40 mg once every 2 weeks after 1-week treatment. At week 4, 8 and 12, the psoriasis area severity index（PASI）and physician′s global assessment （PGA） scores were recorded, and clinical efficacy and adverse drug reactions were observed. In patients with psoriatic arthritis, the improvement of arthritis was evaluated according to the American College of Rheumatology 20% response criteria （ACR20）. Results All the 14 patients received the drug treatment for at least 12 weeks. At week 4, 8 patients achieved 50% reduction in PASI （PASI 50）. At week 8, 8 patients achieved PASI 75, and 2 of the 8 patients achieved PASI 90. At week 12, 14 patients achieved PASI 75, 7 of them achieved PASI 90, and 3 of them achieved PASI 100. Before the treatment, the average PGA score of the 14 patients were 4.92 ± 0.02, and decreased to 1.21 ± 0.02 at week 12. The arthritis symptom was markedly improved in the 3 patients with psoriatic arthritis. At week 8, 2 patients achieved ACR20, and 3 achieved ACR20 at week 12. There were no serious adverse drug reactions such as serious infections and malignant tumors in any of the patients. Urticaria occurred in 3 patients, and was relieved after antihistamine treatment. Conclusion Subcutaneous injection of adalimumab every other week is markedly effective and safe for the treatment of severe psoriasis with few adverse drug reactions, and it provides a new treatment choice for patients with severe psoriasis who show no response to traditional therapy.

Key words: Psoriasis, Arthritis, psoriatic, Biological agents, Adalimumab