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Abstract
Background Psoriasis is an inflammatory skin disease characterised by increased cell signalling via cytokines and chemokines. A wide variety of treatment options are available including systemic biological treatments such as tumour necrosis factor antagonist infliximab.
Purpose To evaluate the effectiveness and safety of infliximab for the treatment of psoriasis in adults.
Material and methods Observational, retrospective study, from 2008 to 2014, in patients with psoriasis treated with infliximab in a tertiary hospital.
Data were obtained from the electronic medical history supported by Selene Clinical Station. Data collected were demographics, average treatment dose and duration, previous treatments, dose escalation and Psoriasis Area and Severity Index (PASI).
Results The study included 27 patients (66.7% males), mean age 49.7 years (25–88). The treatment protocol was infliximab 5 mg/kg infused as indicated in the Summary of Product Characteristics. The average dose and duration were 393.38 mg (300–585.22) and 4.074 years (1–6), respectively. Previous treatments used were 44.4% topical corticosteroids, 14.8% phototherapy, 18.5% ciclosporin, 44.4% methotrexate, 18.5% adalimumab and 7.4% etanercept.
Regarding treatment effectiveness, 7.4% of patients showed some resistance, 33.33% experienced some outbreaks and 59.2% became totally asymptomatic. The average PASI at baseline was 6.83 (0–50) and 1.9 (0–16) at the end. Intensification of treatment was indicated in 25.9% of patients who changed their infusion from every 8 to 6 weeks. Dose reduction was possible in 7.4% of patients with a dose of 4 mg/kg.
During treatment, 7.4% of patients had lower respiratory tract infections, 7.4% tonsillitis and 3.7% herpes zoster.
Conclusion
Most of the patients had a good response to treatment. Infliximab should be considered in patients who have failed to respond to, have a contraindication for, or are intolerant of, other systemic treatments.
Some of the patients developed infections. Risks and benefits of infliximab must be carefully considered prior initiating treatment in patients with chronic or recurrent infections.
References and/or Acknowledgements
References and/or AcknowledgementsNo conflict of interest.