Humira's Results in the REVEAL Clinical Trial

Fast and Effective for Moderate to Severe Psoriasis

Humira Proves its Worth

Like a lot of large drug studies, the name REVEAL is actually an acronym which stands for "The Randomized controlled EValuation of adalimumab Every other week in moderate to severe psoriasis triAL". Since that's quite a mouthful, we'll stick to "REVEAL" for short. The purpose of the study was to prove that Humira was effective for psoriasis of the skin. Previously, we looked at some skin data from the Humira for psoriatic arthritis trial - but now we have skin-specific data from a trial designed to look at just that.

How was it done?

This was a 52 week double-blind, placebo-controlled trial. What that means is that some patients got drug, some got a placebo or inert substance but neither patient not study doctors knew who got what until the end of the trial so as not to bias the results. The dosing of Humira for skin psoriasis includes a double dose of drug 80mg on the first day, an extra 40mg of drug a week later, then the standard 40mg every two weeks is given thereafter.

What Was Measured?

Researchers looked at the "PASI 75" which refers to the percentage of patients who achieved a 75% clearing of their psoriasis from their baseline PASI evaluation as well as PASI 90 and other measures.

What Where the Results?

REVEAL showed that 71% of patients on Humira achieved PASI 75 at 16 weeks vs. 7% of the placebo patients. Looking at speed of improvement, the 19% of Humira patients reached PASI 75 at week 4 - a pretty impressive result.

What About Safety Issues?

The REVEAL trial reported that the rate of serious adverse events with Humira was similar to placebo, about 1.8%.

Take Home Message

Humira is both quick and effective for moderate to severe psoriasis. Consideration should be given to side effects and also to the required monitoring for these drugs. Other biologics should also be considered before deciding if Humira is the right choice any given patient.

_{source: Menter A, et. al. Adalimumab therapy for moderate to severe psoriasis: A randomized, controlled phase III trial. J Am Acad Dermatol 2008;58:1006-15}