As with all TNF-α inhibitors, caution should be exercised when using these agents in patients with predisposing conditions.[61] A multi-center, randomized, doubleblind, placebo-controlled study involving 147 patients with moderate-to-severe psoriasis compared subcutaneous injections of 40 mg of adalimumab weekly, 40 mg of adalimumab every other week and placebo. This evidence concerns the gene TNF and psoriasis.