Infliximab for severe, treatment-resistant psoriasis: a prospective, open-label study.

摘要: BACKGROUND Infliximab, a mouse-human chimeric monoclonal antibody directed against tumour necrosis factor-alpha, has been shown to be effective for moderate severe psoriasis, but there are few data published on its use in recalcitrant, treatment-resistant disease or combination with other antipsoriatic therapies. OBJECTIVES To report our experience infliximab the treatment of patients attending tertiary referral service recalcitrant disease. METHODS All psoriasis who were treated between 2002 and July 2005 entered into prospective, open-label study. Details phenotype, clinical course adverse events recorded together measures severity [Psoriasis Area Severity Index (PASI), Dermatology Life Quality Index, photography] at baseline, weeks 2 6, then 2-monthly intervals throughout period. RESULTS Twenty-three during study; one patient had pustular was therefore excluded from statistical analysis. (baseline PASI 26.5+/-6.7, mean+/-SD, n=22) received least two systemic therapies past; 16 taking more concomitant time initiation. At week 10, 95% achieved 50% greater improvement baseline (PASI 50), 77% 75% 75). Efficacy sustained longer term, eight 10 than 11 months maintaining 50. Only withdrawn due lack efficacy, suffered infections including extrapulmonary tuberculosis (splenic abscess) cellulitis, six have discontinued effects infusion reactions (two), thrombocytopenia (one), hepatitis (one) malignancy (two). CONCLUSIONS Data this study suggest that is rapidly severe, disease, although approximately 25% discontinue therapy development serious effects. Long-term follow-up, continued pharmacovigilance, further controlled comparative studies will required evaluate fully risks associated context already difficult treat population.