BACKGROUND: Adalimumab, a fully human, anti-TNFα monoclonal antibody has been shown to be effective for moderate-to-severe psoriasis in clinical trial setting. However, only a limited number of studies reflect everyday clinical experience with this drug.OBJECTIVES: To provide evidence on the efficacy, dose optimization and safety of adalimumab based on everyday clinical experience in a tertiary referral centre for psoriasis, in Greece.METHODS: We retrospectively reviewed the records of all patients with moderate-to-severe psoriasis who received adalimumab, in our referral centre, between January 2008 and October 2010.RESULTS: In total, 52 patients were treated with adalimumab for a mean period of 14 months (range 4-30 months). Mean baseline Psoriasis Area and Severity Index (PASI) was 16.7 (range 9-40.3). At 4, 6, 12 and 18 months, PASI75 was attained by 68%, 82%, 89% and 88% of patients respectively. Nineteen of 52 patients (36%) reached a PASI100 at a mean time of 10 months (range 4-18 months). The dose interval between the injections of adalimumab was increased from 2 to 3 weeks for 14 patients (27%) who achieved and sustained a PASI100 after the first year of treatment, without any relapse. The overall rate of adverse events reached 38%, but treatment was discontinued only in two cases (4%).CONCLUSIONS: Our study demonstrates that adalimumab is effective and safe in patients with moderate-to-severe psoriasis in short- and long-term setting. At the same time, it points out novel and interesting issues for further investigation.