Remicade safe and effective in plaque psoriasis among psoriatic arthritis patients

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Infliximab safe and effective in plaque psoriasis among psoriatic

arthritis patients

Rheumawire

Aug 11, 2004

Mann

New York, NY -The TNF inhibitor infliximab (Remicade, Centocor) improves

plaque psoriasis in patients with psoriatic arthritis (PsA), according

to results of a phase 2 study presented as a poster at the annual summer

meeting of the American Academy of Dermatology in July [1].

This retrospective analysis of a phase 2, multicenter, randomized,

double-blind, placebo-controlled study found that 98.7% of PsA patients

with plaque psoriasis receiving 5-mg/kg of infliximab had minimal/clear

disease by week 10, compared with those who received placebo. The study

included 78 PsA patients who had plaque-type psoriasis. Patients

received placebo, 3 mg/kg, or 5 mg/kg of infliximab at 0, 2, and 6

weeks.

" Infliximab treatment resulted in greater improvement compared with

placebo in all measures of efficacy for plaque psoriasis in PsA

patients, " the researchers reported.

Researchers assessed outcomes via the Psoriasis Activity and Severity

Index (PASI) and physicians' global assessment (PGA) of disease activity

(PGA). The median PASI at baseline was 21.8.

Specifically, the onset of a more than 75% improvement on PASI was rapid

and notable by week 4 in infliximab patients, and the onset of more than

50% improvement was rapid and notable by week 3, the study showed.

Patients also reported improvements in health-related quality of life.

Study patients were 18 years or older and had previously undergone

treatment with psoralen plus ultraviolet light A (PUVA) and/or systemic

therapy. Of the cohort, 76.4% were male and 85.9% were white.

According to PGA, disease was minimal or clear rapidly, notable by week

2 in the infliximab groups. In addition, Infliximab treatment was safe

and no serious infusion-site reactions occurred.

" Of all the new biologic therapies moving forward or approved for

psoriasis, this is the drug that performs the best, " says study

researcher Dr Craig Leonardi (St Louis University, Missouri). " In

general, it's not a first-line drug for psoriasis, but it is a place

that you can go to make a wonderful thing happen in patients with the

most severe form of psoriasis, " he says, adding that it also does a nice

job on moderate to severe psoriasis. " By the time patients come to see

me, they are looking for the best possible drug for their problem. The

idea that very highly effective therapies can be used chronically is

also promising. In the past, psoriasis patients cycled on and off

various medications because of side effects, but biologic therapies

appear poised to deliver our wish list of highly effective safe drugs

that can be used continuously. "

" The efficacy and safety profiles [of infliximab] are impressiveand the

cost is impressive, " Leonardi says. " One of the biggest hang-ups is that

the intravenous nature [of infliximab] is a challenge for dermatologists

to learn how to use as part of their clinical armamentarium. Certainly,

this is a more complicated drug to use in practice. "

Infliximab is currently FDA-approved for treating rheumatoid arthritis

and Crohn's disease.

Studies of dosing strategies for infliximab in psoriatic arthritis are

ongoing.

Source

Gottleib A, R, Shu L, et al. Infliximab improves

signs of plaque psoriasis in patients with psoriatic arthritis. American

Academy of Dermatology '04 meeting; July 28-August 1, 2004; New York

City, NY. Poster 81.

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org